Post-Operative C-Reactive Protein as a Predictor of Anastomotic Leak Following Robotic Colorectal Surgery

Area of Science:

• Colorectal Surgery
• Surgical Outcomes
• Biomarkers

Background:

• Postoperative C-reactive protein (CRP) is a key indicator for anastomotic leaks (AL) in colorectal surgery.
• Established CRP thresholds for open and laparoscopic surgery range from 162-195 mg/L on postoperative day 3.

Purpose of the Study:

• To establish a predictive C-reactive protein (CRP) cut-off value for anastomotic leaks (AL) in robotic colorectal surgery.
• To identify patients eligible for early discharge based on CRP levels within enhanced recovery after surgery (ERAS) protocols.

Main Methods:

• Retrospective analysis of 784 patients undergoing elective robotic colorectal resection with primary anastomosis.
• Clinically and radiologically confirmed anastomotic leaks (AL) were the primary outcome measure.
• Data analyzed using IBM SPSS v30.0.0.

Main Results:

• An anastomotic leak (AL) occurred in 6.5% of patients.
• Postoperative day-3 CRP of 136.0 mg/L and postoperative day-4 CRP of 94.4 mg/L predicted AL.
• A postoperative day-5 CRP cut-off of 243 mg/L predicted AL requiring re-operation or escalated care.

Conclusions:

• Postoperative CRP levels effectively predict anastomotic leaks (AL), aiding early detection and exclusion.
• CRP thresholds for robotic colorectal surgery are lower than those for open or laparoscopic procedures.
• Utilizing CRP levels can facilitate early patient discharge within ERAS pathways.