C-reactive protein in gastrointestinal system anastomosis
Hızır Yakup Akyıldız, Tarık Artış, Alper Akcan, Can Küçük, Erdoğan Sözüer, Fatih Mutlu
Erciyes Üniversitesi, Tıp Fakültesi, Genel Cerrahi AD, KAYSERİ
Purpose: We aimed to evaluate the accuracy of blood C-reactive protein level for early diagnosis of anastomotic leakage that is ahead of the possible dangerous process after gastrointestinal anastomosis.
Materials and Methods: Between 1 January 2007 and 31 June 2007, 93 patients with anastomosis were prospectively evaluated. Postoperative clinical course, hemogram, biochemical examination and blood CRP levels were evaluated on 1.,3., and 5. days postoperatively. Anastomotic leakage was defined clinically. Patients without any clinical anastomotic problem during the follow-up formed group 1 whilst patients with anastomotic problems constituted group 2.
Results: There were 43 female, 50 male patients. Anastomotic leakage was present in 9 patients (%9.7). Six of them required additional surgical intervention and 3 of them were treated conservatively. Between groups, there were not significantly difference with regards to demographical data, comorbidities, operative causes, postoperative course, biochemical examination and complications except anastomotic leak. CRP levels were similar at postoperative 1.day, but at 3. and 5. days, there were highly significant differences between groups (p<0.001). White blood cell count was not statistically different at 1. and 3. days after operation in patients with anastomotic leakage., but at 5. day, it was significantly higher (p<0.01).
Conclusion: To achieve the early diagnosis of anastomotic leak, the evaluation of the CRP level at 3. day after operation may be helpful for the physician.
Keywords: Anastomotic leak, CRP, surgery