English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

. The tendency to the wide implementation of the enhanced recovery after surgery (ERAS) protocol in the clinical practice leads to the increased requirement in surgical safety that can be provided with the possible earliest detection of postoperative complications and appropriate treatment. This requirement is the most acute in gastric cancer surgery, where despite the improvement of surgical techniques and complex treatment approach the rate of postoperative complications and esophagojejunal anastomotic leakage (EAL) is still high, making up 27% and 10%, respectively. The measurement of C-reactive protein (CRP) concentration in blood plasma is the simplest, most accessible and reliable method to detect infectious complications. However, CRP concentrations, which may indicate the development of postoperative complications, differ significantly in different studies.The aim of the study was to specify the role of CRP as a predictive biomarker for infectious complications and esophagojejunal anastomotic leakage.Materials and methods. This retrospective study included immediate outcomes of the planned radical gastrectomy in 130 patients. The CRP level was assessed depending on the complication type in the immediate postoperative period. Correlation between CRP levels and the incidence of postoperative infectious complications was analyzed. The severity grade of postoperative complications was registered according to the modified Clavien-Dindo classification. The statistical analysis was performed using parametrical and non-parametrical methods. The optimal cut-off CRP for infectious complications and anastomotic leakage was defined with the use of the ROC analysis. The multifactorial ANOVA was performed to detect the effect of contributing factors on the CRP level.Results. An increase in CRP levels over 100 mg/L on the fourth day after surgery can be considered as a manifestation of infectious complications (AUC 0,866  0,042, 95% CI: 0,798-0,934, p 0,001), and an increase in CRP levels over 167 mg/L on the fifth day is a predictor of the development of EAL (AUC 0,869  0,081, 95% CI: 0,711-1,000, p = 0,001). Initial malnutrition and aggravated somatic status appear to be risk factors for the development of infectious complications (p 0,001).Conclusion. Therefore, despite its low specificity, CRP is a sensitive marker of postoperative infectious complications starting from the first days of the postoperative period. Evaluation of the CRP concentration in dynamics allows identifying postoperative complications before the development of clinical manifestations.

C-Reactive Protein as a Diagnostic Tool for Infectious Complications and Esophagojejunal Anastomotic Leakage after Gastrectomy