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

null Anonymous; D. Clerc; R. Blanco-Colino; A. Otto; D. Nepogodiev; G. Pagano; V. Schaeff; A. Soares; G. Zaffaroni; R. Zebrak; J. Hodson; R. Blanco-Colino; J. C. Glasbey; F. Pata; G. Pellino; A. Sgro; A. Soares; T. van Elst; S. Van Straten; C. H. Knowles; D. Nepogodiev; J. Hodson; A. Borakati; M. F. Bath; I. H. Yasin; K. Mclean; T. Arthur; M. Kovacevic; S. Delibegovic; M. Karamanliev; M. Swamad; R. Paramasivam; A. Martensen; H. M. Larsen; L. Raedeker; P. E. Frey; A. Kechagias; A. Venara; E. Duchalais; A. Ioannidis; F. Pata; G. Pellino; S. Pasquali; A. Sgro; A. Simioni; V. Farina; M. Podda; L. Lorenzon; V. Schaeff; A. Otto; EuroSurg Collaborative; STARSurg Collaborative; Sara Kuiper; Laurents Stassen; Niels Sluijpers; Kelly van de Pas; S.J. Chapman

doi:10.1002/bjs.11326

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

Anonymous, D. Clerc, R. Blanco-Colino, A. Otto, D. Nepogodiev, G. Pagano, V. Schaeff, A. Soares, G. Zaffaroni, R. Zebrak, J. Hodson, R. Blanco-Colino, J. C. Glasbey, F. Pata, G. Pellino, A. Sgro, A. Soares, T. van Elst, S. Van Straten, C. H. KnowlesD. Nepogodiev, J. Hodson, A. Borakati, M. F. Bath, I. H. Yasin, K. Mclean, T. Arthur, M. Kovacevic, S. Delibegovic, M. Karamanliev, M. Swamad, R. Paramasivam, A. Martensen, H. M. Larsen, L. Raedeker, P. E. Frey, A. Kechagias, A. Venara, E. Duchalais, A. Ioannidis, F. Pata, G. Pellino, S. Pasquali, A. Sgro, A. Simioni, V. Farina, M. Podda, L. Lorenzon, V. Schaeff, A. Otto, EuroSurg Collaborative, STARSurg Collaborative, Sara Kuiper, Laurents Stassen, Niels Sluijpers, Kelly van de Pas, S.J. Chapman^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background 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.

Original language	English
Pages (from-to)	E161-E169
Number of pages	9
Journal	British Journal of Surgery
Volume	107
Issue number	2
DOIs	https://doi.org/10.1002/bjs.11326
Publication status	Published - 1 Jan 2020

Keywords

ACUTE KIDNEY INJURY
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10.1002/bjs.11326

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Anonymous, Clerc, D., Blanco-Colino, R., Otto, A., Nepogodiev, D., Pagano, G., Schaeff, V., Soares, A., Zaffaroni, G., Zebrak, R., Hodson, J., Blanco-Colino, R., Glasbey, J. C., Pata, F., Pellino, G., Sgro, A., Soares, A., van Elst, T., Van Straten, S., ... Chapman, S. J. (2020). Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery. British Journal of Surgery, 107(2), E161-E169. https://doi.org/10.1002/bjs.11326

@article{46a60bda95234262a595a4cb2782ddab,

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

abstract = "Background 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.",

keywords = "ACUTE KIDNEY INJURY, RISK",

author = "Anonymous and D. Clerc and R. Blanco-Colino and A. Otto and D. Nepogodiev and G. Pagano and V. Schaeff and A. Soares and G. Zaffaroni and R. Zebrak and J. Hodson and R. Blanco-Colino and Glasbey, {J. C.} and F. Pata and G. Pellino and A. Sgro and A. Soares and {van Elst}, T. and {Van Straten}, S. and Knowles, {C. H.} and D. Nepogodiev and J. Hodson and A. Borakati and Bath, {M. F.} and Yasin, {I. H.} and K. Mclean and T. Arthur and M. Kovacevic and S. Delibegovic and M. Karamanliev and M. Swamad and R. Paramasivam and A. Martensen and Larsen, {H. M.} and L. Raedeker and Frey, {P. E.} and A. Kechagias and A. Venara and E. Duchalais and A. Ioannidis and F. Pata and G. Pellino and S. Pasquali and A. Sgro and A. Simioni and V. Farina and M. Podda and L. Lorenzon and V. Schaeff and A. Otto and {EuroSurg Collaborative} and {STARSurg Collaborative} and Sara Kuiper and Laurents Stassen and Niels Sluijpers and {van de Pas}, Kelly and S.J. Chapman",

year = "2020",

month = jan,

day = "1",

doi = "10.1002/bjs.11326",

language = "English",

volume = "107",

pages = "E161--E169",

journal = "British Journal of Surgery",

issn = "0007-1323",

publisher = "Oxford University Press",

number = "2",

}

Anonymous, Clerc, D, Blanco-Colino, R, Otto, A, Nepogodiev, D, Pagano, G, Schaeff, V, Soares, A, Zaffaroni, G, Zebrak, R, Hodson, J, Blanco-Colino, R, Glasbey, JC, Pata, F, Pellino, G, Sgro, A, Soares, A, van Elst, T, Van Straten, S, Knowles, CH, Nepogodiev, D, Hodson, J, Borakati, A, Bath, MF, Yasin, IH, Mclean, K, Arthur, T, Kovacevic, M, Delibegovic, S, Karamanliev, M, Swamad, M, Paramasivam, R, Martensen, A, Larsen, HM, Raedeker, L, Frey, PE, Kechagias, A, Venara, A, Duchalais, E, Ioannidis, A, Pata, F, Pellino, G, Pasquali, S, Sgro, A, Simioni, A, Farina, V, Podda, M, Lorenzon, L, Schaeff, V, Otto, A, EuroSurg Collaborative, STARSurg Collaborative, Kuiper, S, Stassen, L, Sluijpers, N, van de Pas, K & Chapman, SJ 2020, 'Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery', British Journal of Surgery, vol. 107, no. 2, pp. E161-E169. https://doi.org/10.1002/bjs.11326

TY - JOUR

T1 - Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery

AU - Anonymous, null

AU - Clerc, D.

AU - Blanco-Colino, R.

AU - Otto, A.

AU - Nepogodiev, D.

AU - Pagano, G.

AU - Schaeff, V.

AU - Soares, A.

AU - Zaffaroni, G.

AU - Zebrak, R.

AU - Hodson, J.

AU - Blanco-Colino, R.

AU - Glasbey, J. C.

AU - Pata, F.

AU - Pellino, G.

AU - Sgro, A.

AU - Soares, A.

AU - van Elst, T.

AU - Van Straten, S.

AU - Knowles, C. H.

AU - Nepogodiev, D.

AU - Hodson, J.

AU - Borakati, A.

AU - Bath, M. F.

AU - Yasin, I. H.

AU - Mclean, K.

AU - Arthur, T.

AU - Kovacevic, M.

AU - Delibegovic, S.

AU - Karamanliev, M.

AU - Swamad, M.

AU - Paramasivam, R.

AU - Martensen, A.

AU - Larsen, H. M.

AU - Raedeker, L.

AU - Frey, P. E.

AU - Kechagias, A.

AU - Venara, A.

AU - Duchalais, E.

AU - Ioannidis, A.

AU - Pata, F.

AU - Pellino, G.

AU - Pasquali, S.

AU - Sgro, A.

AU - Simioni, A.

AU - Farina, V.

AU - Podda, M.

AU - Lorenzon, L.

AU - Schaeff, V.

AU - Otto, A.

AU - EuroSurg Collaborative

AU - STARSurg Collaborative

AU - Kuiper, Sara

AU - Stassen, Laurents

AU - Sluijpers, Niels

AU - van de Pas, Kelly

AU - Chapman, S.J.

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Background 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.

AB - Background 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.

KW - ACUTE KIDNEY INJURY

KW - RISK

U2 - 10.1002/bjs.11326

DO - 10.1002/bjs.11326

M3 - Article

SN - 0007-1323

VL - 107

SP - E161-E169

JO - British Journal of Surgery

JF - British Journal of Surgery

IS - 2

ER -

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

Abstract

Keywords

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