Introduction Controversy pertaining to whether or not preoperative chemo and radiotherapy worsen immediate postoperative outcomes after colorectal surgery continues to persist. Data for a large number of patients from a standardised national dataset may allow an adequate evaluation of their influence on postoperative outcomes after colorectal surgery.
Method Patients who underwent colorectal surgery for cancer from 2012–2013 were identified from the NSQIP database. Patients who underwent preoperative chemotherapy (<30 days prior to surgery) and/or radiotherapy (<90 days prior to surgery) were compared to those who had surgery alone for complications classified as major and minor using chi-squared, Fisher’s Exact tests and logistic regression with p < 0.05 being considered statistically significantly.
Results Of the 2,936 CRC patients selected, 2,431 (82.8%) underwent colorectal resection alone, 127 (4.3%) received chemotherapy, 45 (1.5%) radiotherapy and 333 (11.3%) chemoradiotherapy. When comparing patients who underwent preoperative chemoradiotherapy to those who had surgery alone, the chemoradiotherapy group had a lower mean age (59 vs. 66 years, p < 0.0001), a higher proportion of males (64% vs. 52%, p < 0.0001) and rectal tumours (97% vs. 27%, p- < 0.0001). Both groups had similar BMI and ASA class. Patients who received chemoradiation had a greater occurrence of deep vein thrombosis (OR: 2.66; 95% CI: 1.28–5.52, p = 0.02) and deep incisional SSI (OR: 2.76: 95% CI: 1.48–5.16, p = 0.0009). Other outcomes were similar (Table 1).
Conclusion Patients who undergo preoperative chemotherapy and radiotherapy prior to surgery for colorectal cancer are at greater risk for postoperative thromboembolic complications and surgical site infection. Since both these complications are potentially preventable, an awareness of the increased risks in these patients along with greater scrutiny and adoption of preventive strategies will likely reduce these complications.
Disclosure of interest None Declared.
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