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- W2032701488 abstract "<b>Objectives</b> To evaluate the effect of postoperative use of non-steroidal anti-inflammatory drugs (NSAIDs) on anastomotic leakage requiring reoperation after colorectal resection. <b>Design</b> Cohort study based on data from a prospective clinical database and electronically registered medical records. <b>Setting</b> Six major colorectal centres in eastern Denmark. <b>Participants</b> 2766 patients (1441 (52%) men) undergoing elective operation for colorectal cancer with colonic or rectal resection and primary anastomosis between 1 January 2006 and 31 December 2009. Median age was 70 years (interquartile range 62-77). <b>Intervention</b> Postoperative use of NSAID (defined as at least two days of NSAID treatment in the first seven days after surgery). <b>Main outcome measures</b> Frequency of clinical anastomotic leakage verified at reoperation; mortality at 30 days. <b>Results</b> Of 2756 patients with available data and included in the final analysis, 1871 (68%) did not receive postoperative NSAID treatment (controls) and 885 (32%) did. In the NSAID group, 655 (74%) patients received ibuprofen and 226 (26%) received diclofenac. Anastomotic leakage verified at reoperation was significantly increased among patients receiving diclofenac and ibuprofen treatment, compared with controls (12.8% and 8.2% <i>v</i> 5.1%; P<0.001). After unadjusted analyses and when compared with controls, more patients had anastomotic leakage after treatment with diclofenac (7.8% (95% confidence interval 3.9% to 12.8%)) and ibuprofen (3.2% (1.0% to 5.7%)). But after multivariate logistic regression analysis, only diclofenac treatment was a risk factor for leakage (odds ratio 7.2 (95% confidence interval 3.8 to 13.4), P<0.001; ibuprofen 1.5 (0.8 to 2.9), P=0.18). Other risk factors for anastomotic leakage were male sex, rectal (<i>v</i> colonic) anastomosis, and blood transfusion. 30 day mortality was comparable in the three groups (diclofenac 1.8% <i>v</i> ibuprofen 4.1% <i>v</i> controls 3.2%; P=0.20). <b>Conclusions</b> Diclofenac treatment could result in an increased proportion of patients with anastomotic leakage after colorectal surgery. Cyclo-oxygenase-2 selective NSAIDs should be used with caution after colorectal resections with primary anastomosis. Large scale, randomised controlled trials are urgently needed." @default.
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- W2032701488 date "2012-09-26" @default.
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- W2032701488 title "Postoperative use of non-steroidal anti-inflammatory drugs in patients with anastomotic leakage requiring reoperation after colorectal resection: cohort study based on prospective data" @default.
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- W2032701488 doi "https://doi.org/10.1136/bmj.e6166" @default.
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