Value of C-Reactive Protein and Procalcitonin in Detection of Intestinal Leak after Colorectal Anastomosis: A systematic review and Meta-Analysis | ||
| The Egyptian Journal of Surgery | ||
| Volume 44, Issue 4, October 2025, Pages 1146-1155 PDF (713.21 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/EJSUR.2025.361962.1399 | ||
| Authors | ||
| Mostafa Omar Abdel Aziz; Mohammed Ali Nada; Mohammed AlZalabany* ; Ibrahim Magid Abdel Maksoud | ||
| Department of Surgery, Faculty of Medicine, Ain Shams University, Egypt. | ||
| Abstract | ||
| Background: After colorectal anastomosis, anastomotic leak (AL) is a serious postoperative complication linked to higher rates of morbidity and death. Improving patient outcomes requires early detection. Procalcitonin (PCT) and C-reactive protein (CRP) have been suggested as possible biomarkers for the early detection of AL. Objective: Through a comprehensive review and meta-analysis, this work seeks to assess the diagnostic accuracy of PCT and CRP in identifying intestinal leaks after colorectal anastomosis. Patients and Methods: ThisThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria were followed in this systematic review and meta-analysis. To find pertinent research published in the last 15 years, a thorough literature search was carried out throughout PubMed, Scopus, Web of Science, and the Cochrane Library. Clinical trials evaluating PCT and CRP as biomarkers for AL diagnosis in adult patients having elective colorectal surgery made up the inclusion criteria. Two independent reviewers extracted the data, and a Bayesian random-effects model was used for meta-analysis. Results: A total of eligible studies were included, encompassing a diverse patient population. The meta-analysis revealed that CRP and PCT exhibited significant diagnostic accuracy, with CRP demonstrating early elevation on postoperative days 3 to 5. PCT was also a reliable marker, particularly when combined with CRP, enhancing sensitivity and specificity for AL detection. Conclusion: After colorectal anastomosis, CRP and PCT are useful indicators for the early identification of AL. When used in tandem, they improve diagnostic precision, which may enable prompt intervention and lower the risk of surgical complications. Future studies should concentrate on improving cut-off values and assessing how they function in clinical judgment. | ||
| Keywords | ||
| Anastomotic leak; biomarkers; colorectal surgery; C-reactive protein; procalcitonin | ||
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