A Comparative Study Of C-reactive Protein Predicting Postoperative Infection Between Open And Laparoscopic Gastrointestinal Carcinoma Surgery

Objective: Postoperative infection is one of common complications of gastrointestinal carcinoma surgery,which has adverse effects on postoperative rehabilitation and prognosis of patients.C-reactive protein(CRP),as an important predictor of infection,plays a crucial role in determining postoperative infection of gastrointestinal carcinoma.However,there are few reports on comparative advantages of CRP in predicting postoperative infection between open and laparoscopic gastrointestinal carcinoma surgery.The purpose of this study is to compare the diagnostic accuracy for CRP predicting postoperative infective complications between open and laparoscopic gastrointestinal carcinoma surgery.Methods: During the period from December,2015 to January,patients with gastrointestinal cancer who had been underwent surgery in the First Hospital of China Medical University were recorded in a database,according to operation method,they were divided into open group and laparoscopic group.Serum CRP level was detected routinely from POD 1 to POD 5,corresponding conclusions were drawn through the analysis of data and ROC curves.Results: ROC curves showed that CRP levels of POD 4 had the highest diagnostic accuracy for predicting postoperative infection in open group(AUC=0.740),providing a sensitivity of 0.605(95% CI,0.434-0.760)and a specificity of 0.800(95% CI,0.654-0.904),and the best threshold(cut-off)was 112.50mg/l.And in laparoscopic group,CRP levels of POD 2 had the highest diagnostic accuracy for postoperative infective complications(AUC = 0.860)with a sensitivity of 0.786(95%CI,0.591-0.917)and a specificity of 0.809(95% CI,0.714-0.882),the best threshold(cut-off)was 142.50mg/l.Conclusion: The accuracy of postoperative CRP levels for predicting postoperative infection of laparoscopic gastrointestinal carcinoma is superior to traditional open surgery,and a day 2 CRP>142.50mg/l in laparoscopic surgery should be suspected the development of postoperative infective complications.