C-reactive protein is a predictor of complications after elective laparoscopic colorectal surgery: five-year experience

INTRODUCTION: With the development and improvement of laparoscopic surgery, procedures have become common. However, post-operative complications occur when patients are released from hospital. These complications increase patients’ morbidity and mortality. They also lead to re-hospitalization, an extended recovery period, and an increase in the cost of treatment. AIM: To evaluate and determine the prognostic properties of C-reactive protein in the early diagnosis of postoperative complications after a laparoscopic colon resection. MATERIAL AND METHODS: The prospective study included patients who underwent laparoscopic colorectal surgery in 2010–2014. The patients were divided into two groups – uncomplicated ones and those with complications. C-reactive protein concentrations in their blood serum were measured on the 2(nd), 4(th) and 6(th) day after surgery. Logistic regression analysis was used to evaluate the relation between C-reactive protein values measured on the 2(nd), 4(th) and 6(th) postoperative day and related complications. Receiver operating characteristic curves were used to determine the sensitivity and specificity of each C-reactive protein value measured on the 2(nd), 4(th) and 6(th) postoperative day. RESULTS: One hundred and six patients were included in the trial; 14 of them had complications. On the second day, a C-reactive protein cut-off value of 88.6 mmol/l provided the highest sensitivity and specificity for predicting evolving complications, being 71.4% and 84.8% respectively (p = 0.003). The significant predictive cut-off value decreases and becomes more sensitive and specific each post-operative day. CONCLUSIONS: It is possible to detect developing post-operative complications early on by monitoring C-reactive protein concentration levels in the blood serum on the 2(nd), 4(th), and 6(th) post-operative days.