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C-reactive protein as a marker of the surgical stress reduction within an ERAS protocol (Enhanced Recovery After Surgery) in colorectal surgery: A prospective cohort study.

Title: C-reactive protein as a marker of the surgical stress reduction within an ERAS protocol (Enhanced Recovery After Surgery) in colorectal surgery: A prospective cohort study.
Authors: Cabellos Olivares M; Department of Anesthesia, Hospital Universitario de Guadalajara, Guadalajara, Spain.; Labalde Martínez M; Department of Surgery, Hospital 12 de Octubre, Madrid, Spain.; Torralba M; Department of Internal Medical, Research Unit, Hospital Universitario de Guadalajara. Universidad de Alcalá, Guadalajara, Spain.; Rodríguez Fraile JR; Department of Anesthesia, Hospital Universitario de Guadalajara, Guadalajara, Spain.; Atance Martínez JC; Department of Health Inspection, Hospital Universitario de Guadalajara. Universidad de Alcalá, Guadalajara, Spain.
Source: Journal of surgical oncology [J Surg Oncol] 2018 Mar; Vol. 117 (4), pp. 717-724. Date of Electronic Publication: 2018 Jan 22.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Wiley-Liss Country of Publication: United States NLM ID: 0222643 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1096-9098 (Electronic) Linking ISSN: 00224790 NLM ISO Abbreviation: J Surg Oncol Subsets: MEDLINE
Imprint Name(s): Publication: : Hoboken, NJ : Wiley-Liss; Original Publication: New York, Plenum.
MeSH Terms: C-Reactive Protein/*metabolism ; Gastrointestinal Diseases/*metabolism ; Gastrointestinal Diseases/*surgery; Biomarkers/metabolism ; Colectomy/adverse effects ; Colectomy/methods ; Colorectal Neoplasms/metabolism ; Colorectal Neoplasms/surgery ; Digestive System Surgical Procedures/methods ; Diverticular Diseases/metabolism ; Diverticular Diseases/surgery ; Inflammatory Bowel Diseases/metabolism ; Inflammatory Bowel Diseases/surgery ; Aged ; Cohort Studies ; Female ; Humans ; Male ; Prospective Studies ; Retrospective Studies
Abstract: Background: The aim of this study is to evaluate the effectiveness of an Enhanced Recovery After Surgery Protocol (ERAS) in relation to reduce the Systemic Inflammatory Response (SIR) to surgery using C-reactive protein (CRP) in the first (POD1), second (POD2) and third (POD3) postoperative day.; Methods: We enrolled 121 patients (ERAS group) that underwent elective colorectal surgery with ERAS, and compared them with 135 patients (preERAS group) that had undergone surgery prior to the implementation. We made a univariate analysis to compare the CRP values in POD1, POD2, and POD3 between preERAS/ERAS group, laparoscopic/open surgery and the presence or not of Clavien Dindo complications. Multivariable lineal regression was used to assess if the ERAS had a decreasing effect on the CRP in POD1, POD2, and POD3, and was adjusted by age, male sex, use of laparoscopy, and complications.; Results: The presence of complications was independently associated with an increase in CRP values ​​in POD1, POD2, and POD3. Laparoscopy in POD1 and POD2, and ERAS in POD2 was independently associated with a decrease in CRP values.; Conclusion: The analysis shows an increase in SIR measured as a CRP value in those patients that had complications. The SIR decreased with laparoscopy in POD1 and POD2 and with ERAS in POD2.; (© 2018 Wiley Periodicals, Inc.)
Contributed Indexing: Keywords: C-reactive protein; colorectal surgery; enhanced recovery after surgery protocol; systemic inflammatory response
Substance Nomenclature: 0 (Biomarkers); 9007-41-4 (C-Reactive Protein)
Entry Date(s): Date Created: 20180123 Date Completed: 20180409 Latest Revision: 20180409
Update Code: 20260130
DOI: 10.1002/jso.24909
PMID: 29355975
Database: MEDLINE

Journal Article