Assessment of Relation between Recurrence of Enterocutaneous Fistula and Preoperative C-reactive Protein Level after Complete Surgical Repair

Background: Recurrence of enterocutaneous fistula after the definite surgical repair has not changed significantly. In postoperative complication of abdominal surgery, serum C-reactive protein level is used for evaluation of severity of the condition. In this study, we aim to find a relation between recurrence of enterocutaneous fistula and preoperative serum level of C-reactive protein. Methods: A prospective study of 40 patients admitted with the diagnosis of enterocutaneous fistula (ECF) and prepared for definite surgical repair in the form of resection anastomosis of ECF. We used preoperative serum C-reactive protein as predicting factor of recurrence and independent variable for timing of surgery. Results: Eleven cases showed recurrence with increased level of preoperative serum level of C-reactive protein above (0.75 mg/dl) with high significant (P<0.05). There was significant different between recurrent and non-recurrent cases regarding preoperative serum level albumin and malnutrition (P<0.05). Conclusion: C-reactive protein can be used as predicting factor for recurrence of ECF after definite surgical treatment as well as helping surgeon to take decision for proper time of operation.

[1]  A. Hill,et al.  Systematic review and meta‐analysis of use of serum C‐reactive protein levels to predict anastomotic leak after colorectal surgery , 2014, The British journal of surgery.

[2]  P. Nyström,et al.  Outcome of 132 Consecutive Reconstructive Operations for Intestinal Fistula—Staged Operation Without Primary Anastomosis Improved Outcome in Retrospective Analysis , 2013, Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society.

[3]  J. Galloway,et al.  Definitive surgical treatment of enterocutaneous fistula: outcomes of a 23-year experience. , 2013, JAMA surgery.

[4]  U. Güller,et al.  Safe and Early Discharge After Colorectal Surgery Due to C-Reactive Protein: A Diagnostic Meta-Analysis of 1832 Patients , 2012, Annals of surgery.

[5]  Suk-Hwan Lee Surgical Management of Enterocutaneous Fistula , 2012, Korean journal of radiology.

[6]  V. Kate,et al.  Enterocutaneous Fistulae: Etiology, Treatment, and Outcome – A Study from South India , 2011, Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association.

[7]  W. Schecter Management of enterocutaneous fistulas. , 2011, The Surgical clinics of North America.

[8]  A. Forbes,et al.  The Management of Enterocutaneous Fistula in a Regional Unit in the United Kingdom: A Prospective Study , 2010, Diseases of the colon and rectum.

[9]  J. Hiatt,et al.  Risk factors for recurrence after repair of enterocutaneous fistula. , 2009, Archives of surgery.

[10]  J. Fischer,et al.  Current management of enterocutaneous fistula , 2006, Journal of Gastrointestinal Surgery.

[11]  J. Connor,et al.  Clinical Outcome and Factors Predictive of Recurrence After Enterocutaneous Fistula Surgery , 2004, Annals of surgery.

[12]  M. Schein,et al.  Gastrointestinal fistulas associated with large abdominal wall defects: Experience with 43 patients , 1990, The British journal of surgery.

[13]  J. Pinto-de-Sousa,et al.  Elevated serum C-reactive protein as a predictive factor for anastomotic leakage in colorectal surgery. , 2012, International journal of surgery.