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Predictive value of inflammatory markers for postoperative recovery following colorectal surgery

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

Using biological markers to predict serious complications and global postoperative recovery, to ensure safe and timely patient discharge after elective colorectal surgery represents a major challenge. The aim of this study was to demonstrate that C-reactive protein levels < 172 mg/l on postoperative day 3 were associated with postoperative recovery within 5 days.

Methods

This is a prospective study of a consecutive bicentric cohort. Successive patients scheduled for bowel resection with anastomosis, without stoma, were included. The main composite endpoint for overall postoperative recovery included absence of fever, absence of pain > 2 on the visual analog scale, intestinal gas transit, and patient autonomy for mobility and body care.

Results

One hundred sixty-height patients, with a mean age of 65 years old, were analyzed. Ninety patients (53%) underwent right colectomy and 131 (77%) were operated on by laparoscopy. Severe postoperative complications were observed in 11 patients (6%). One hundred twenty patients (71%) recovered within 5 days. C-reactive protein levels < 172 mg/L on postoperative day 3 had a negative predictive value of 80% to predict recovery within 5 days. Ninety-five percent of patients with C-reactive protein < 172 mg/L at postoperative day 3 had no severe postoperative complications.

Conclusion

Levels of C-reactive protein < 172 mg/L at postoperative day 3 corresponded with an early recovery in 80% of cases, thus allowing safe and early discharge without risk of serious complications.

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Authors and Affiliations

  1. Department of Digestive Surgery, Vendée Medical Center, Les Oudairies, 85000, La Roche-sur-Yon, France

    Emeric Abet, Farouk Drissi, Clément Couëtte, Marc-Henri Jean & Fabrice Denimal

  2. Department of Digestive and Endocrine Surgery, University Hospital of Nantes, 1, Place Alexis Ricordeau, 44093, Nantes, France

    Farouk Drissi, Juliette Podevin, Emilie Duchalais & Guillaume Meurette

Authors
  1. Emeric Abet
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  2. Farouk Drissi
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  3. Clément Couëtte
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  4. Marc-Henri Jean
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  5. Fabrice Denimal
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  6. Juliette Podevin
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  7. Emilie Duchalais
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  8. Guillaume Meurette
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Contributions

Emeric Abet contributed to study design, collected and analyzed the data, and revised the manuscript. Farouk Drissi collected and analyzed data and wrote the manuscript. Clement Couëtte collected and analyzed data and co-wrote the manuscript. Marc-Henri Jean and Juliette Podevin recruited patients. Fabrice Denimal recruited patients and analyzed data. Emilie Duchalais recruited patients, contributed to data collection and analysis. Guillaume Meurette contributed to study design and data analysis. He recruited patients and revised the manuscript.

Corresponding author

Correspondence to Farouk Drissi.

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Abet, E., Drissi, F., Couëtte, C. et al. Predictive value of inflammatory markers for postoperative recovery following colorectal surgery. Int J Colorectal Dis 35, 1125–1131 (2020). https://doi.org/10.1007/s00384-020-03594-y

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  • DOI: https://doi.org/10.1007/s00384-020-03594-y

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