Abstract
Background: In colorectal cancer, CRP levels on postoperative days 3-4 have a strong negative predictive value for an anastomotic leak, with threshold values of ~15 on POD 3 and ~13 on POD 4. In Crohn’s disease, CRP levels are perceived as unreliable in the postoperative period because of the underlying inflammatory process. The aim of this study was to investigate the use of postoperative CRP levels in patients with Crohn’s Disease and set threshold values for this population. Methods: This is a retrospective study of the medical records of adult patients with Crohn’s Disease who underwent bowel anastomoses, at a single, high volume center. The operations were performed by a single colorectal consultant who is an inflammatory bowel disease specialist, between 1/2012 and 12/2017. Results: 92 operations were performed. Mean CRP levels and CRP threshold values were higher in the study’s population compared with studies on colorectal cancer patients. A CRP level of 19.56 mg\dL on postoperative day 3 had an area under the curve of 0.865 (sensitivity 88%, specificity 73%) and a NPV of 98% for an anastomotic leak. Patients with an anastomotic leak showed a trend towards decreased postoperative albumin levels (p=0.06). Conclusions: Postoperative CRP values are higher in Crohn’s Disease compared with colorectal cancer. Postoperative CRP levels may rule out anastomotic leaks in patients with Crohn’s Disease with threshold values of 20.3 mg/dL in POD 3, 19.5 mg/dL in POD 4 and 16.7 mg\dL in POD 5.
Postoperative complication rates between Crohn's disease and Colorectal cancer patients after ileocolic resections: a comparative study
