Perioperative nonselective non-steroidal anti-inflammatory drugs are not associated with anastomotic leakage after colorectal surgery
- PMID: 24912914
- DOI: 10.1007/s11605-014-2486-4
Perioperative nonselective non-steroidal anti-inflammatory drugs are not associated with anastomotic leakage after colorectal surgery
Abstract
Introduction: 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.
Methods: 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.
Results: 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).
Conclusions: 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.
Comment in
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NSAID use and colorectal anastomotic leaks. Caution and further investigation.J Gastrointest Surg. 2014 Aug;18(8):1405-6. doi: 10.1007/s11605-014-2564-7. Epub 2014 Jun 11. J Gastrointest Surg. 2014. PMID: 24916588 No abstract available.
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Surgery. NSAIDs and risk of anastomotic leaks after colorectal surgery.Nat Rev Gastroenterol Hepatol. 2014 Sep;11(9):523-4. doi: 10.1038/nrgastro.2014.130. Epub 2014 Jul 29. Nat Rev Gastroenterol Hepatol. 2014. PMID: 25069542
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