TPW 1.06 From Biomarker to Escalation: POD3 C-Reactive Protein, Imaging Timing, and Length of Stay Following Robotic Left-Sided Colorectal Cancer Surgery

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ID: 324045
2026
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Abstract
Abstract Background Postoperative day-3 (POD3) C-reactive protein (CRP) is a well-established predictor of complications following colorectal surgery. However, how CRP drives escalation to postoperative imaging and whether imaging timing influences outcomes remains unclear. This study evaluated the relationship between POD3 CRP, CT imaging escalation, imaging timing, and length of stay (LOS). Methods A retrospective cohort study was conducted of 102 patients undergoing elective robotic left-sided colorectal cancer resection at a tertiary centre between 24/05/2021 and 11/06/2024. A CRP trigger was defined as CRP >150 mg/L on POD3–4. Postoperative complications were classified using Clavien–Dindo, with major complications defined as grade ≥III. Escalation was defined as CT imaging for suspected complications. CT scans were classified as early (≤24 h from CRP trigger) or delayed (>24 h). LOS was defined as the index hospital admission. Results The median age was 66 years (IQR 58–74), and 61% were male. Postoperative complications occurred in 32/102 patients (31.4%), including 13 (12.7%) major complications. Imaging was performed in 35/102 patients (34.3%), predominantly in patients with confirmed complications. Nineteen CT scans demonstrated actionable findings. Higher POD3 CRP was significantly associated with escalation to CT imaging (p<0.001). In CRP-triggered patients, early CT imaging was associated with reduced median LOS compared with delayed imaging (13 vs 17 days), with no observed difference in major complication rates. Conclusion In robotic colorectal cancer surgery, POD3 CRP aligns with escalation to high-yield postoperative imaging. Earlier CT imaging is associated with reduced LOS without increased morbidity, supporting early CRP-guided imaging.
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Authors Ahmed Muqames, Ahmed Alani
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.291
URL
https://doi.org/10.1093/bjs/znag087.291
Keywords Keywords not found

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