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Nonsteroidal anti-inflammatory drugs and the risk of anastomotic leakage after anterior resection for rectal cancer
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.ORCID iD: 0000-0003-4958-6965
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
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2017 (English)In: European Journal of Surgical Oncology, ISSN 0748-7983, E-ISSN 1532-2157, Vol. 43, no 10, p. 1908-1914Article in journal (Refereed) Published
Abstract [en]

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) have been widely used in colorectal surgery due to their opioid-sparing effect. However, several studies have indicated an increased risk of anastomotic leakage following NSAID treatment, although conflicting results exist. The primary goal of this study was to further examine whether postoperative NSAIDs are independently associated with anastomotic leakage after anterior resection for rectal cancer. Methods: Patients who underwent anterior resection for rectal cancer during 2007-2013 in 15 different hospitals in three healthcare regions in Sweden were included in the study. Registry data and information from patient records were retrieved. The association between NSAID treatment (for at least two days in the first postoperative week) and symptomatic anastomotic leakage (within 90 days) was evaluated with multiple logistic regression, with adjustment for pertinent confounding factors. Results: Some 1495 patients were included in the study. Of these, 27% received postoperative NSAIDs for at least two days in the first postoperative week. Symptomatic anastomotic leakage occurred in 11% and 14% in the NSAID and non-NSAID group, respectively. With adjustment for confounders, the odds ratio for leakage among patients who received NSAIDs compared with those who did not was 0.88 (95% CI 0.65-1.20). No differences were seen between non-selective and COX-2-selective NSAIDs. Conclusion: Postoperative NSAID treatment does not seem to increase the risk of symptomatic anastomotic leakage after anterior resection for rectal cancer. NSAID use appears to be safe, but a well-powered randomized clinical trial is warranted.

Place, publisher, year, edition, pages
Elsevier, 2017. Vol. 43, no 10, p. 1908-1914
Keywords [en]
NSAID, COX-2 selective, Non-selective, Anastomotic dehiscence, Postoperative complications
National Category
Cancer and Oncology Surgery
Identifiers
URN: urn:nbn:se:umu:diva-141825DOI: 10.1016/j.ejso.2017.06.010ISI: 000413615600014PubMedID: 28687432OAI: oai:DiVA.org:umu-141825DiVA, id: diva2:1160424
Available from: 2017-11-27 Created: 2017-11-27 Last updated: 2018-06-09Bibliographically approved

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Kverneng Hultberg, DanielRutegård, JörgenRutegård, Martin

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