Upgrade Program Implementation at Colorrectal Surgery and Complications: Early Diagnosis

Upgrade Program Implementation at Colorrectal Surgery and Complications: Early Diagnosis

The anastomotic leak (AL) is a very serious complication in colorectal surgery not only because of its severity but its frequency. Other facet for study, besides the risk factor and prevention, is the AL early diagnostic, due to minimize the clinical consequences and severity; and avoid the failure-to-recue. Several studies analyze the Creactive protein (CRP) and Procalcitonine (PCT) usefulness in AL predictor before the clinical signs appear.

At a prospective observational study carry on our center, it concluded that CRP at 3rd day after surgery over 15mg/dl was a very important AL predictor, even before the clinical changes appear. The aim of this study is minimize the severity complications and the mortality due to AL appears. The aim of this study is minimize the severity complications and the mortality due to AL by means of introduces an upgrade program in which a CT scan will be conduct in all the patients with high CRP levels at 3rd, 4th or 5th postoperative day, with the goal to know the AL early and make all the therapeutic step to minimize the consequences.

Inclusion Criteria:

• Patients over 18 years of age.
• Patients undergoing elective colorectal surgery due to neoplastic or non-neoplastic etiology.
• Patients with an anastomosis performed in the surgical act.
• Signed informed consent.

Exclusion Criteria:

• Patients who require transfer to another center.
• Patients with fatal evolution: those who require urgent reoperation for an inarverted perforation, early leakage of anastomosis or death before the third postoperative day.