Predictive value of 4th post-operative-day CRP in the early detection of complications after laparoscopic bowel resection for endometriosis - 16/04/21

Doi : 10.1016/j.jogoh.2021.102148

Dr. Océane Pécheux ^a,^⁎ , Mrs. Dilé Pauline ^b, Dr Yohan Kerbage ^b, Prof. Piessen Guillaume ^b,^d, Mrs. Deken Valérie ^c, Prof. Collinet Pierre ^b,^d, Prof. Chrystèle Rubod ^b,^d
^a Douai hospital, Route de Cambrai - BP 10740 F-59507 Douai Cedex, France
^b Centre Hospitalier Régional Universitaire de Lille, Hôpital Jeanne de Flandre, 2 avenue Oscar Lambret 59000 Lille, France
^c Department of Biostatistics, Univ. Lille, CHRU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, F-59000 Lille, France
^d Université Lille CHRU Lille F-59000 Lille, France

^⁎Corresponding author: Dr. Océane Pécheux, Work phone: 0327047729; Personal address: Douai hospital, route de Cambrai Route de Cambrai - BP 10740 F-59507 Douai Cedex, FranceDouai hospitalroute de Cambrai Route de Cambrai - BP 10740Douai CedexF-59507France

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ABSTRACT

Objective

Post-operative CRP on postoperative day 4 (POD) is used for the early detection of complications after colorectal surgery for cancer, but there is no evidence yet that justifies the use of this marker for bowel resection in case of endometriosis.

Study design

We retrospectively included 66 consecutive patients who underwent bowel resection for endometriosis (stage 4) in Lille university hospital, France, from August 1, 2015 until January 31, 2017.The composite endpoint of our study included anastomotic leakages, infectious or thrombo-embolic complications, hematomas, bowel stenosis, rectorrhagia, voiding dysfunction, and rehospitalization for related symptoms.

Results

CRP on POD 4 presents a satisfying area under the curve of 0.85, for the composite endpoint. A CRP cut off value of 56mg/L yielded a sensitivity of 0.61 (IC95%: 0.36 to 0.83) and a specificity of 0.98 (IC95%: 0.89 to 1). The negative and positive predictive values were 0.87 and 0.92.

Conclusion

The negative predictive value of the CRP on POD 4 after bowel resection for endometriosis is a useful early indicator for detecting a complication. Therefore, this biomarker might be safely used as an additional criterion for a safe discharge from hospital after colorectal resection in endometriosis.

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Keywords : Endometriosis, CRP, Bowel resection, Anastomotic leak, Post-operative complication