Background: Surgical treatment for rectal cancer may cause complications that exacerbate the condition, lengthen hospital stays, and raise healthcare costs. Rectal cancer surgery complications can be detected immediately with postoperative C-reactive protein (CRP) monitoring. Elevated levels of CRP indicate the presence of inflammation and can serve as a predictive factor for future outcomes.
Methods: A retrospective cohort analysis was performed on 67 rectal cancer surgery patients. Prior to and after surgery, CRP levels were measured on days 1-3 and 4-7. Postoperative complications were linked to CRP, surgical approach (open, laparoscopic, conversion), and patient characteristics. This study included t-tests, chi-square tests, Mann-Whitney U tests, ANOVA, Pearson and Spearman correlation analyses, and logistic regression.
Results: There was a significant correlation between high levels of CRP on postoperative days 4-7 and the development of problems (p < 0.001). The ratios of CRP/albumin and CRP/platelet were highly predictive of problems over this period (p = 0.000033). Patients who encountered problems had a notably greater estimated blood loss (p = 0.0086). Logistic regression analysis demonstrated a statistically significant relationship between higher Charlson Comorbidity Index (CCI) scores and an elevated probability of experiencing problems (p = 0.0078). Moreover, patients who underwent laparoscopic surgery but had to be converted to an open method saw a notably greater incidence of complications (p = 0.0022). From a financial standpoint, the average cost per patient with complications was EUR 1128.75, resulting in a total cost of EUR 44,021.25 for all 39 patients. Conversely, patients who did not experience any difficulties had a cost of EUR 731.25 per patient, resulting in a total of EUR 20,475.00 for all 28 patients.
Conclusions: Regularly monitoring CRP, particularly between days 4 and 7 following surgery for rectal cancer, can promptly identify any complications. Monitoring CRP levels and promptly managing any abnormalities can enhance surgical outcomes and reduce healthcare costs.
Keywords: C-reactive protein (CRP); CRP ratios; estimated blood loss (EBL); healthcare costs; postoperative complications; rectal cancer surgery; surgical approach.