Safety of surgery within 24h following colonoscopy for colorectal cancer: a retrospective propensity scores matched analysis

Introduction In clinical practice, clinicians often perform repeat colonoscopy before colorectal cancer (CRC) surgery to accurately assess tumor location, size, and the presence of other underlying lesions. No previous study has reported the safety of the interval from colonoscopy to laparoscopic CRC surgery on surgical outcomes. The purpose of this study was to evaluate the safety of the interval from colonoscopy to laparoscopic CRC surgery on surgical outcomes using propensity score matching (PSM). Methods The patients who underwent CRC surgery were retrospectively collected from a single clinical teaching hospital from Jan 2008 to Jan 2021. The interval from colonoscopy to laparoscopic CRC surgery was divided into the colonoscopy within 24-hours group and the colonoscopy over 24-hours group. The short-term outcomes were compared between the two groups. Results A total of 5439 patients were included in this study. There were 529 CRC patients in the colonoscopy within 24-hours group and 4910 patients in the colonoscopy over 24-hours group before PSM. After 1:1 ratio PSM, there were 529 patients in each group and no significant difference was found in the two groups (p>0.05) in terms of baseline information. As for short-term outcomes, the colonoscopy within 24-hours group had 11.2 ± 7.1 days’ postoperative hospital stay which was longer than that of 10.4 ± 6.1 days’ postoperative hospital stay in the colonoscopy over 24-hours group (p<0.05), however, no significant difference was found in operation time (p=0.098), intra-operative blood loss (p=0.445), retrieved lymph nodes (p=0.409), overall complications (p=0.135) or Clavien-Dindo ≥ grade 3 complications (p=0.652) between the two groups. Conclusion Colonoscopy within 24-hours prior to laparoscopic CRC surgery is safe.