Impact Factor: 5.2 IJAR
Intestinal resection and anastomosis is still by far the most common alimentary tract surgery done by the present day general surgeons. Resection done for various pathological causes, require an anastomosis method for the restoration of continuity of the intestine. This is associated with varied degree of morbidity and mortality. The breakdown of the suture line may result in peritonitis, fecal fistula formation and other fatal septic complications. Safety in the gastrointestinal surgery may
... s depend to a great extent on the factors that influence the healing of anastomosis, technical expertise of the operating surgeon in performing anastomosis and the type of anastomosis. However, with adequate supervision, there is little difference between the outcomes of anastomosis performed by trainees and those performed by established surgeons. Aim and Objectives: To assess the changes occurring in the level of CRP with respect to the septic complications among patients undergoing elective colorectal surgery. 1. To assess the accuracy of C-reactive protein as an early predictor of septic complications after elective colorectal surgery. Methods: Patients admitted in JSS medical college and hospital, Mysore during the study period i.e. October 2013 to October 2015, satisfying inclusion and exclusion criteria were studied. Who have undergone elective colorectal surgery. A standard Performa will be used during the initial evaluation of the patient to Obtain the relevant information. One Blood sample for CRP before surgery and other samples on postoperative days 2, 4, 6 and 9 will be taken. All the measurements are done using SPSS version 21.0. The graphs were made using Microsoft Excel. Results: In our study, APR accounted for majority of the procedure, in which 4 out of 10 cases had septic complications, 8 patients underwent LAR and 2 of them had septic complication. In total 30 colonic procedures 6 developed complication i.e. 20% (p-0.4), which is statistically less significant, probably as they are all elective surgeries. In our study after elective colorectal surgery, surgical site infections were 16.7%, anastomotic leak 6.7% and mortality occurred in one patient i.e., 3.33%. The diagnostic accuracy of CRP on POD 2 and POD 4 as a predictor of septic complications after elective colorectal surgery. Our study showed CRP level, reached maximum on POD 4. So POD 4 CRP level has maximum sensitivity of (83.33%), specificity of (91.67%) and positive predictive value of 71.43% in the prediction of postoperative septic complications. The mean cut of value of CRP in our study was 125 mg/l. Conclusion: Our study suggested that serial CRP measurements after elective colorectal surgery could be used as a diagnostic biomarker in the early prediction of postoperative septic complications. The present study shows that measurement of CRP on 4 th POD can be used as an indicator for safe discharge from hospital after colorectal surgery.