Perioperative nonselective non-steroidal anti-inflammatory drugs are not associated with anastomotic leakage after colorectal surgery
| Autor: | Josephine Kwong, Joshua J. Gnanasegaram, Allan Okrainec, Fayez A. Quereshy, Luciano Ambrosini, Fady Saleh, Timothy D. Jackson |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Colon medicine.medical_treatment Anastomotic Leak Drug Administration Schedule Perioperative Care Cohort Studies Colon surgery Risk Factors Odds Ratio Medicine Humans Prospective cohort study Colectomy Aged Retrospective Studies Aged 80 and over Pain Postoperative business.industry Anastomosis Surgical Anti-Inflammatory Agents Non-Steroidal Gastroenterology Rectum Retrospective cohort study Odds ratio Perioperative Middle Aged Colorectal surgery Surgery body regions Ketorolac Logistic Models Treatment Outcome Anesthesia Multivariate Analysis Female business medicine.drug |
| Zdroj: | Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. 18(8) |
| ISSN: | 1873-4626 |
| Popis: | Recent evidence raises concern about the use of perioperative non-steroidal anti-inflammatory drug (NSAID) use after colorectal resection. The purpose of this retrospective cohort study was to investigate the relationship between perioperative ketorolac use and anastomotic leakage after colorectal surgery. A retrospective review (2004–2011) was performed on patients who underwent elective colorectal surgery. Univariate analysis and multivariate logistic regression were used to evaluate the association between patients who did not receive any NSAIDs and those who received ketorolac within the first 5 days perioperatively and leak rate. A total of 731 patients were identified as having resection with primary anastomosis: 376 (51.4 %) received no NSAIDs and 355 (48.6 %) received ketorolac perioperatively within 5 days after their surgery. There were 24 (3.3 %) leaks, with 12 in both the no NSAIDs (3.2 %) and ketorolac (3.4 %) groups, odds ratio (OR) 1.06 (0.43, 2.62; p = 0.886). Adjusting for smoking, steroid use, and age, there remained no significant difference between ketorolac use and leakage, OR 1.21 (0.52, 2.84; p = 0.660). In our multivariate model, only smoking was a significant predictor of postoperative leak, OR 3.34 (1.30, 8.62; p = 0.021). There does not appear to be a significant association between perioperative ketorolac use and anastomotic leakage after colorectal surgery. However, further prospective studies are needed to confirm our findings before definitive guidelines on NSAID use perioperatively can be recommended. |
| Databáze: | OpenAIRE |
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