Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery

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dc.authoridMaffioli, Anna/0000-0001-7116-4019
dc.authoridBisgin, Tayfun/0000-0001-7040-4228
dc.authoridOrtenzi, Monica/0000-0002-6508-6488
dc.authoridYILDIRIM, REYYAN/0000-0003-3417-7245
dc.authoridJegathees, Thuvarahan/0000-0001-6478-3946
dc.authoridOzmen, Berk Baris/0000-0001-7803-1868
dc.authoridHübner, Martin/0000-0002-4521-8279
dc.authorwosidMaffioli, Anna/AAE-4226-2020
dc.authorwosidBisgin, Tayfun/HJH-6299-2023
dc.authorwosidOrtenzi, Monica/AFV-9079-2022
dc.authorwosidYILDIRIM, REYYAN/AAG-9890-2021
dc.authorwosidJegathees, Thuvarahan/IWY-4053-2023
dc.authorwosidOzmen, Berk Baris/AAB-7045-2019
dc.authorwosidHübner, Martin/J-6715-2017
dc.contributor.authorAnonymous
dc.contributor.authorClerc, D.
dc.contributor.authorBlanco-Colino, R.
dc.contributor.authorOtto, A.
dc.contributor.authorNepogodiev, D.
dc.contributor.authorPagano, G.
dc.contributor.authorSchaeff, V.
dc.date.accessioned2024-06-12T11:17:30Z
dc.date.available2024-06-12T11:17:30Z
dc.date.issued2020
dc.departmentTrakya Üniversitesien_US
dc.description.abstractBackground Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results A total of 4164 patients were included, with a median age of 68 (i.q.r. 57-75) years (54 center dot 9 per cent men). Some 1153 (27 center dot 7 per cent) received NSAIDs on postoperative days 1-3, of whom 1061 (92 center dot 0 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4 center dot 6 versus 4 center dot 8 days; hazard ratio 1 center dot 04, 95 per cent c.i. 0 center dot 96 to 1 center dot 12; P = 0 center dot 360). There were no significant differences in anastomotic leak rate (5 center dot 4 versus 4 center dot 6 per cent; P = 0 center dot 349) or acute kidney injury (14 center dot 3 versus 13 center dot 8 per cent; P = 0 center dot 666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35 center dot 3 versus 56 center dot 7 per cent; P < 0 center dot 001). Conclusion NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement.en_US
dc.identifier.doi10.1002/bjs.11326
dc.identifier.endpageE169en_US
dc.identifier.issn0007-1323
dc.identifier.issn1365-2168
dc.identifier.issue2en_US
dc.identifier.pmid31595986en_US
dc.identifier.startpageE161en_US
dc.identifier.urihttps://doi.org/10.1002/bjs.11326
dc.identifier.urihttps://hdl.handle.net/20.500.14551/24731
dc.identifier.volume107en_US
dc.identifier.wosWOS:000489168500001en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherOxford Univ Pressen_US
dc.relation.ispartofBritish Journal Of Surgeryen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAcute Kidney Injuryen_US
dc.subjectRisken_US
dc.titleSafety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgeryen_US
dc.typeArticleen_US

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