The levels of CRP in non-complicated patients with total laparoscopic hysterectomy and its role in predicting vaginal cuff hematoma

INTRODUCTION: We aimed to evaluate the mean C-reactive protein (CRP) levels in the patients who did not have any complications other than cuff hematoma after total laparoscopic hysterectomy (TLH) in order to determine the CRP levels to predict the potential to develop postoperative cuff hematoma.
METHODS: The study was designed prospectively. The CRP levels, white blood cell (WBC) count, and haemoglobin values (Hb) of 106 patients, who underwent TLH for benign reasons, were measured preoperatively and on the days 1,2 and 7 postoperatively. The laboratory parameters of the patients who developed postoperative cuff hematoma were compared to those of the patients, who did not have any complications.
RESULTS: Of a total of 106 patients who underwent a laparoscopic hysterectomy, there were no differences in the demographic characteristics between the groups. The duration of operation was significantly longer in the group of patients with cuff hematoma (p<0.05). In the hematoma group, the level of CRP was statistically significantly different on POD7 (p<0.05).
DISCUSSION AND CONCLUSION: We are of the opinion that CRP levels below the cut-off value of 12.5 mg/L measured on the postoperative 7th day indicate tissue damage secondary to surgical trauma, while care should be exercised to detect any possible complications in the patients with higher CRP levels above this value. We suggest that routine follow-up of the CRP levels may provide a cautious approach after a laparoscopic hysterectomy, allowing for early diagnosis and treatment for potentially developing complications including cuff hematoma and postoperative infections.