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Use of inflammatory markers in the early detection of infectious complications after laparoscopic colorectal cancer surgery with the ERAS protocol
INTRODUCTION: Thanks to laparoscopy and enhanced recovery protocols (ERAS) it is possible to shorten hospitalization. Therefore, it seems reasonable to search for new early markers of infectious complications in order to select patients who are prone to development of complications. AIM: To assess t...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Termedia Publishing House
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174169/ https://www.ncbi.nlm.nih.gov/pubmed/30302144 http://dx.doi.org/10.5114/wiitm.2018.75846 |
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author | Wierdak, Mateusz Pisarska, Magdalena Kuśnierz-Cabala, Beata Kisielewski, Michał Major, Piotr Witowski, Jan S. Ceranowicz, Piotr Strzałka, Marcin Budzyński, Andrzej Pędziwiatr, Michał |
author_facet | Wierdak, Mateusz Pisarska, Magdalena Kuśnierz-Cabala, Beata Kisielewski, Michał Major, Piotr Witowski, Jan S. Ceranowicz, Piotr Strzałka, Marcin Budzyński, Andrzej Pędziwiatr, Michał |
author_sort | Wierdak, Mateusz |
collection | PubMed |
description | INTRODUCTION: Thanks to laparoscopy and enhanced recovery protocols (ERAS) it is possible to shorten hospitalization. Therefore, it seems reasonable to search for new early markers of infectious complications in order to select patients who are prone to development of complications. AIM: To assess the usefulness of serum levels of C-reactive protein, interleukin-6 and procalcitonin as early indicators of infectious complications in patients after laparoscopic colorectal surgery with ERAS. MATERIAL AND METHODS: The prospective analysis included consecutive patients who underwent laparoscopic colorectal cancer resection. The following parameters were included in the analysis: C-reactive protein (CRP), interleukin 6 (IL-6) and procalcitonin measured on postoperative days (PODs) 1, 2, 3. Patients were divided into two groups: uncomplicated (group 1) and complicated (group 2). The difference in levels of the markers and the dynamics of changes observed in both groups were analyzed. RESULTS: Group 1 comprised 34 patients, and group 2 consisted of 17 patients. A significant increase of both absolute values and delta increments on all postoperative days was noted. ROC curve analysis showed that the best cut-off values indicating an infectious process were: CRP 129 mg/l on POD3 (92% sensitivity/80% specificity), IL-6 of 78 pg/ml on POD2 (91% sensitivity/97% specificity) and PCT 0.24 ng/ml on POD3 (93% sensitivity/68% specificity). CONCLUSIONS: Our study showed that regular measurement of all analyzed markers in the early postoperative days may be beneficial in the detection of postoperative infectious complications. Further studies are needed to fully assess the role of routine biochemical measurements in the postoperative period after laparoscopic surgery with the ERAS protocol. |
format | Online Article Text |
id | pubmed-6174169 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Termedia Publishing House |
record_format | MEDLINE/PubMed |
spelling | pubmed-61741692018-10-09 Use of inflammatory markers in the early detection of infectious complications after laparoscopic colorectal cancer surgery with the ERAS protocol Wierdak, Mateusz Pisarska, Magdalena Kuśnierz-Cabala, Beata Kisielewski, Michał Major, Piotr Witowski, Jan S. Ceranowicz, Piotr Strzałka, Marcin Budzyński, Andrzej Pędziwiatr, Michał Wideochir Inne Tech Maloinwazyjne Original Paper INTRODUCTION: Thanks to laparoscopy and enhanced recovery protocols (ERAS) it is possible to shorten hospitalization. Therefore, it seems reasonable to search for new early markers of infectious complications in order to select patients who are prone to development of complications. AIM: To assess the usefulness of serum levels of C-reactive protein, interleukin-6 and procalcitonin as early indicators of infectious complications in patients after laparoscopic colorectal surgery with ERAS. MATERIAL AND METHODS: The prospective analysis included consecutive patients who underwent laparoscopic colorectal cancer resection. The following parameters were included in the analysis: C-reactive protein (CRP), interleukin 6 (IL-6) and procalcitonin measured on postoperative days (PODs) 1, 2, 3. Patients were divided into two groups: uncomplicated (group 1) and complicated (group 2). The difference in levels of the markers and the dynamics of changes observed in both groups were analyzed. RESULTS: Group 1 comprised 34 patients, and group 2 consisted of 17 patients. A significant increase of both absolute values and delta increments on all postoperative days was noted. ROC curve analysis showed that the best cut-off values indicating an infectious process were: CRP 129 mg/l on POD3 (92% sensitivity/80% specificity), IL-6 of 78 pg/ml on POD2 (91% sensitivity/97% specificity) and PCT 0.24 ng/ml on POD3 (93% sensitivity/68% specificity). CONCLUSIONS: Our study showed that regular measurement of all analyzed markers in the early postoperative days may be beneficial in the detection of postoperative infectious complications. Further studies are needed to fully assess the role of routine biochemical measurements in the postoperative period after laparoscopic surgery with the ERAS protocol. Termedia Publishing House 2018-05-16 2018-09 /pmc/articles/PMC6174169/ /pubmed/30302144 http://dx.doi.org/10.5114/wiitm.2018.75846 Text en Copyright: © 2018 Fundacja Videochirurgii http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license. |
spellingShingle | Original Paper Wierdak, Mateusz Pisarska, Magdalena Kuśnierz-Cabala, Beata Kisielewski, Michał Major, Piotr Witowski, Jan S. Ceranowicz, Piotr Strzałka, Marcin Budzyński, Andrzej Pędziwiatr, Michał Use of inflammatory markers in the early detection of infectious complications after laparoscopic colorectal cancer surgery with the ERAS protocol |
title | Use of inflammatory markers in the early detection of infectious complications after laparoscopic colorectal cancer surgery with the ERAS protocol |
title_full | Use of inflammatory markers in the early detection of infectious complications after laparoscopic colorectal cancer surgery with the ERAS protocol |
title_fullStr | Use of inflammatory markers in the early detection of infectious complications after laparoscopic colorectal cancer surgery with the ERAS protocol |
title_full_unstemmed | Use of inflammatory markers in the early detection of infectious complications after laparoscopic colorectal cancer surgery with the ERAS protocol |
title_short | Use of inflammatory markers in the early detection of infectious complications after laparoscopic colorectal cancer surgery with the ERAS protocol |
title_sort | use of inflammatory markers in the early detection of infectious complications after laparoscopic colorectal cancer surgery with the eras protocol |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174169/ https://www.ncbi.nlm.nih.gov/pubmed/30302144 http://dx.doi.org/10.5114/wiitm.2018.75846 |
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