Goal of Study: Hospitalization and surgery affect the normal homeostasis. This process is called Systemic Inflammatory Response (SIR). One of the markers of SIR is CRP. The aim of the study is to evaluate the effectiveness of different variables (an Enhanced Recovery After Surgery (ERAS) protocol, laparoscopic surgery, and postoperative Clavien Dindo complications) in relation to reduce the SIR to surgery using an objetive marker as CRP in the first (POD1), second (POD2) and third (POD3) postoperative day according to age (<70 and ≥70 years old), and to compare it between the two groups.
Materials: we enrolled the first 121 consecutive patients that underwent elective colorectal surgery with an ERAS protocol (from May 2016 to January 2017; ERAS group), and compared them with 135 consecutive patients that had undergone surgery prior to the implementation of the program (from January to December
2015; preERAS group), and we divided them over and under the age of 70 years old. 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 postoperative Clavien Dindo complications according to the age. SPSS software (version 20.0) was used for statistical analysis. Chi-square, Fisher exact test and the Student t test were applied as appropiate. Results were considered statistically significant when p value was‹0.05.
Results and Discussion:The groups were well-balanced and no statistical differences between them were found in terms of age, sex, ASA, diagnosis, TNM stage in colorectal cancer, preoperative hemoglobin or the length of surgery. The compliance with the ERAS protocol was 75.2% in <70 years old, and 74.7% in ≥ 70.
CRP value was always lower in the group operated according to an ERAS protocol, but in <70 it was only statistically significant in POD2, while in ≥70, it was significant in POD 1-2-3. Laparoscopy reduced the CRP value in a statiscally significant way in POD1-2-3 in ‹70, but only in POD1 in ≥70. The presence of complications increased the CRP value in POD2-3 in <70 and in POD1-2-3 in ≥70.
Conclusion(s): the use of an ERAS protocol in elective colorectal surgery decreases the SIR to surgery in the postoperative period, mainly in ≥70 years old, measured according to CRP values. Laparoscopy and the absence of postoperative complications are also associated with a lower SIR. More studies are needed to contrast these results.

07 / C-Reactive Protein (CRP) as a marker of the surgical stress reduction in elective colorectal surgery according to age (&lt;70 and =70 years old): a prospective cohort study



07 / C-Reactive Protein (CRP) as a marker of the surgical stress reduction in elective colorectal surgery according to age (&lt;70 and =70 years old): a prospective cohort study

07 / C-Reactive Protein (CRP) as a marker of the surgical stress reduction in elective colorectal surgery according to age (<70 and =70 years old): a prospective cohort study