POD2 CRP Below 100 mg/L May Rule Out Anastomotic Leak

A two-cohort multicenter diagnostic accuracy study evaluated whether postoperative day 2 (POD2) C-reactive protein (CRP) below 100 mg/L could exclude anastomotic leakage after elective colon cancer resection with primary anastomosis. The study reported negative predictive values of 98.8% and 99.0% in the test and validation cohorts respectively, and found that a POD3/POD2 CRP ratio below 1 further stratified risk in patients with higher POD2 CRP, allowing a two-step algorithm under which nearly 90% of patients could be discharged by POD2 or 3 with an anastomotic leak risk near 1%.

Most relevant for: Patients undergoing elective colon cancer resection with primary anastomosis managed within enhanced recovery after surgery (ERAS) pathways.

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