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Chapman SJ, Clerc D, Blanco-Colino R, Otto A, Nepogodiev D, Pagano G, Schaeff V, Soares A, Zaffaroni G, Žebrák R, Hodson J, Blanco-Colino R, Chapman SJ, Glasbey JC, Pata P, Pellino G, Sgrò A, Soares A, 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, Žebrák R, Paramasivam R, Martensen A, Larsen HM, Rädeker L, Frey PE, Kechagias A, Venara A, Duchalais E, Ioannidis A, Pata F, Pellino G, Pasquali S, Sgrò A, Simioni A, Farina V, Podda M, Lorenzon L, Schaeff V, Otto A, Jakubauskas M, Elst TR, Chu M, Fagan PVB, Wells CI, Alagoa João A, Soares A, Juloski J, Clerc D, Ciubotaru C, Popescu S, Yanishev A, Lee S, Ozkan BB, Yagız Sen A, Aktas MK, Baki BE, Yüksek B, Glasbey JC, Kamarajah S, Mclean K, Borakati A, Yasin IH, Khaw RA, Mills E, Goodson R, Thakral N, Ablett AD, Adra M, Kwek I, Khan SM, Quinn P, Manley LR, Badran A, Ramjeeawon A, Campbell A, Tan HL, Rye DS, Rajaraman N, Norman JG, Vutipongsatorn K, Solomou G, Akhbari M, Ali A, Murray V, Baker DM, Brandao BD, Stainer B, et alChapman SJ, Clerc D, Blanco-Colino R, Otto A, Nepogodiev D, Pagano G, Schaeff V, Soares A, Zaffaroni G, Žebrák R, Hodson J, Blanco-Colino R, Chapman SJ, Glasbey JC, Pata P, Pellino G, Sgrò A, Soares A, 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, Žebrák R, Paramasivam R, Martensen A, Larsen HM, Rädeker L, Frey PE, Kechagias A, Venara A, Duchalais E, Ioannidis A, Pata F, Pellino G, Pasquali S, Sgrò A, Simioni A, Farina V, Podda M, Lorenzon L, Schaeff V, Otto A, Jakubauskas M, Elst TR, Chu M, Fagan PVB, Wells CI, Alagoa João A, Soares A, Juloski J, Clerc D, Ciubotaru C, Popescu S, Yanishev A, Lee S, Ozkan BB, Yagız Sen A, Aktas MK, Baki BE, Yüksek B, Glasbey JC, Kamarajah S, Mclean K, Borakati A, Yasin IH, Khaw RA, Mills E, Goodson R, Thakral N, Ablett AD, Adra M, Kwek I, Khan SM, Quinn P, Manley LR, Badran A, Ramjeeawon A, Campbell A, Tan HL, Rye DS, Rajaraman N, Norman JG, Vutipongsatorn K, Solomou G, Akhbari M, Ali A, Murray V, Baker DM, Brandao BD, Stainer B, Thavayogan R, Jones D, Onafowokan OO, Gharooni A, Dabab N, Carlton-Carew S, Kungwengwe G, Gabriel M, Sewart E, Shortland TC, Lawday S, Pockney P, Dawson A, Arthur T, Brumfitt CD, Stewart P, Ng B, Luong JK, Delibegovic S, Ivanov V, Borisova A, Neykov V, Kunčarová K, Kološová B, Antonova T, Farkašová M, Žebrák R, Harbjerg JL, Brandsborg S, Brinck S, Kjaer MD, Mark-Christensen A, Unbehaun KP, Dalsgaard P, Lycke KD, Kechagias A, LeNaoures P, Duchalais E, Brigand C, Dumange E, Gout M, Moehwald C, Prem M, Alhalabi O, Sliwinski S, Krupp J, Gablenz E, Schmitzer L, Kopp A, Steinle J, Gsenger J, Pohl LJ, Riccardi M, Christodoulou IM, Konstantinidis M, Machairas N, Zoikas A, Balalis D, Manatakis DK, Aguilera ML, Sgrò A, Simioni A, Marano L, Fleres F, Lovisetto F, Sasia D, Segalini E, Pata G, Lucchi A, Sagnotta A, Campagnaro T, Petrelli F, Gallo G, Papandrea M, Testa V, Sinibaldi G, Di Candido F, Colombo F, Perrone G, Aresu S, Biancafarina A, Canonico G, Pagnanelli M, Curletti G, Bini R, Manzoni Garberini A, Impellizzeri H, Cillara N, Tutino R, Picciariello A, Coletta D, Savino G, Ferrara F, Tamini N, Talamo G, Parini D, Giamundo P, lo Conte A, Pagano G, Ripetti V, Pesce A, Menduni N, Pellino G, Giudicissi R, Podda M, Goldin E, Rega D, Belli A, Andriola V, Gordini L, Pata F, Foppa C, Piccolo G, Birindelli A, Ferrari C, Ballarini Z, Tirelli F, Milone M, De Rosa M, Pipitone Federico NS, Molteni B, Tilocca PL, Sancini G, Piozzi GN, Lauretta A, Poillucci G, Mulas S, Schaeff V, Otto A, Jakubauskas M, Simcikas D, Portelli L, Wijnbergen JWM, Dinger TL, Doesschate SFH, Dalen ASHM, Bos DD, Hansmann M, Medina Feliz J, Kuiper SZ, Abdulrahman Z, Pruijssers SR, Farik S, Elliott BM, Geneta VP, Chu M, Wilton S, Kandelaki H, Peng SL, Campbell S, Lim YK, Yassaie SS, Murray M, Fagan PVB, Haran C, Tan J, Castro J, Laranjeira A, Catarino S, Neves-Marques C, Correia JG, Vieira BN, Quintela AC, Serra ML, Maciel J, Cunha M, Aparício DJ, Neves J, Azevedo J, Romano M, Eiró F, Romano J, Monteiro C, Claro M, Almeida MR, Peyroteo M, Machado ND, Capote H, Ferreira M, Sousa X, Devesa H, Cavadas D, Guerreiro I, Costa M, Salman M, English C, Mohammed N, Popescu S, Yanishev A, Litvin A, Ćuk VV, Mészárosová K, Van Straten S, Jaich R, De Lima H, Brooks S, Marx M, Nshalati Salvation M, Clerc D, Blaser B, Piazza G, Gagliardi B, Serin H, Yagız Sen A, Yurdaor SS, Aktas MK, Arslan E, Kopac O, Uyanik A, Ozmen BB, Tiftik E, Aksoy B, Yalcinkaya A, Ozoglu F, Kocer MD, Bilicen G, Cinar EN, Uslu Ö, Kaya Y, Wong J, Farhan-Alanie MMH, Suresh G, Asif A, Finch BJ, Bhahirathan Y, Herron J, Yi Tew Z, Obukofe R, Russell C, Suchett-Kay I, Netke T, Williams L, Kisiel A, Liu FY, Claireaux H, James P, Mondal A, Kalderon R, Nadama HH, Al-Saraff Z, Tam JPH, Powell-Chandler A, Wood F, Campbell A, Gorgievska R, Ragavoodoo A, Thakrar C, Rojoa D, Palmer C, Davidson K, Giacci L, Hale J, Gan FW, Makin-Taylor R, Hey CY, Toh C, Findlay JM, Griffiths N, Ganesananthan S, Jasionowska S, Poustie M, Wong C, Turner T, Pyc W, Sloper W, Warner C, Coey J, Mason D, Sait S, Kowal M, Shortland TC, Owen M, Saiyed A, Ashworth I, Akbari K, Curran M, Martin P, Parker D, Dawson A, Kwok K, Lye C, Pockney P, Ghaly M, Sammour T, Lewis D, Mundasad R, Wilkes A, Ctercteko G, Stewart P, Delibegovic S, Maslyankov S, Dimov R, Iliev S, Dimitrov D, Marek F, Örhalmi J, Skalický P, Skalický T, Chrz K, Christensen P, Worsøe J, Kristensen ES, Emmertsen KJ, Loeve US, Duchalais E, Mihaljevic AL, Herrle F, Konstantinidis KM, Manatakis DK, Korkolis D, Karanikas I, Aguilera ML, Vincenti L, Anania G, Borghi F, Agresta F, Maretto I, Parisi A, Bucci L, De Palma G, Guglielmi A, Cucinotta E, La Torre F, Cianchi F, Guerrieri M, Lauretta A, Trompetto M, Persiani R, Micheletto G, Rega D, Belli A, Cantafio S, Lovisetto F, Ronconi M, Bisagni PAG, De Prizio M, Tamini N, Sinibaldi G, Franceschi A, Galleano R, Cavallini M, Brescia A, D'Ambra L, Benevento A, Niolu P, Calgaro M, Colangelo E, Grottola T, Altomare DF, Puleo S, Salamone G, Pietrabissa A, Poggioli G, Ripetti V, Erdas E, Ottonello R, Canonico G, Tonini V, Selvaggi F, Sammarco G, Ceccarelli G, De Nisco C, Surgo D, Taglietti L, Ozolins A, Sivinš A, Poskus T, Psaila J, Bemelman WA, Graat LJ, Langenhoff B, Wijnhoven BPL, Ven AHW, Poelman M, Stassen LPS, Slooter G, Acherman YIZ, Hoff C, Gerhards MF, Stommel MWJ, Hazebroek EJ, Geloven AAW, Schasfoort RA, Leeuwen BL, Tuynman JB, Tilburg MWA, Boerma EG, Sharma P, Jenkins B, Bissett IP, Peng SL, Herd A, Gordon A, Vernon D, Omundsen M, Ly J, Reddy A, Bonnet G, Harmston C, Morales M, Francisco V, Costa S, Manso A, Amorim E, Pereira J, Cardoso J, Ourô S, Caratão M, Nascimento C, Ribeiro da Silva B, Taranu V, Dias R, Devesa H, Mendes J, Allen M, Silva A, Carlos S, Barbosa E, Carneiro C, Ramos L, Maciel J, Lencastre L, Martins R, Silva-Vaz P, Ridgway PF, McNamara DA, Cahill R, Hogan A, Larkin J, O'Connell PR, Negoi I, Abelevich A, Ćuk VM, Vician M, Ede C, Sardiwalla I, Mulira S, Montwedi D, Oyomno M, Hübner M, Petermann D, Sauvain MO, Ozben V, Geçim IE, Disçi E, Rencuzogullari A, Kurt A, Bisgin T, Pehlivan M, Isik A, Onur E, Leventoglu S, Haksal MC, Erturk MS, Keskin M, Guner A, Tutcu Sahin S, Ozbalci GS, Pergel A, Albayrak D, Bruce D, Fearnhead N, Arthur J, Harron M, Beattie G, Titu L, Ali A, Saunders M, Phillips J, Dindyal S, Cresswell B, Gercek Y, Lee J, Linn T, Faulkner G, Lockwood S, Rees J, Charalabopoulos A, Campbell B, Kontovounisios C, Amarnath T, Johnson M, Epanomeritakis E, Vigs S, Nastro P, Gilliam A, Smolarek S, Wilson T, Orbell J, McIntyre R, Agarwal T, Hainsworth P, Patel P, Vijay J, Liu B, Dhruva Rao P, Roxburgh C, Vipond M, Youssef H, Thorn C, Schizas A, Denley S, Bowley D, Das K, Cuming T, Saha A, Chung L, Pitt J, Davis P, Jones O, Taylor M, Bhargava A, Haji A, Watson N, Bloom I, Singh B, Norwood M, Gurjar S, Stylianides N, Mirza S, Evans M, Williams G, Patil P, Hernon J, Finch G, Green S, Chapple K, Fafemi O, Warusavitarne J, Samee A, Carden C, Ong L, Verma K, Joseph A, Rawat N, Pinkney T, Oke O, Glen P, Maxwell-Armstrong C, Oliphant R, Garner J, Moug SJ, Middleton S, Lund JN, Smart NJ, Osborn G, Moore T, Raymond T, Knowles CH, Hany TS, Clarke R, Khera G, Brady R, Sellahewa C, Mason C, Torrance A, Lasithiotakis K, Knight J, Pullybank A, Ainsworth P, Reid F, Ramwell A, Maslekar S, George R, Skull A, Holtham S, Muhammad K, Lal R, Varcada M, Smith FM, Howlader M, Defriend D, Kirk S, Richards T, Evans C, Borg C, Telford K, Sarfraz N, Busby K, Hollingshead J, Speake D, Pawa N, West D, Chadwick M, Komolafe O, Richardson S, Thornton M, Goede A, Osborne C, Bandyopadhyay D, Foong J, Lee YJ, Liebenberg P, Mijalkov D, Wells A, Bull N, Ajmera A, Warburton T, Morgan S, Mahmoud A, Schachtel M, Mikhail B, Fomin I, Mekaeil B, Taylor N, Stevenson C, Drane A, Pahalawatta U, Lai LT, 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F, Gori A, Cuicchi D, D'Alessio R, Benvenuto D, Gordini L, Erdas E, Podda F, Cappellacci F, Salaris C, Sanna S, Marcialis J, Mosino L, Peddis M, Melis S, De Donno G, Aru AC, Falsetti E, Parini D, Lanari J, D'Errico U, Bianchini S, Birindelli A, Figà F, Caiazzo A, Selvaggi L, Capozzolo A, Cerra C, Pirillo M, Papandrea M, Cravano S, Libri I, Laquatra N, Isabello A, Truškovs A, Bartnick A, Malcevs E, Machatschek MJ, Alm J, Lapsa S, Delorme M, Zeynalov F, Larnovskis J, Sauka J, Bodrov D, Gailumsis R, Wiemann AM, Müller NL, Jelovskis I, Deksnis D, Bauermeister Potts O, Slimbajevs T, Samalavicius NE, Simcikas D, Nutautiene V, Zeromskas P, Jurgaitis J, Aliosin O, Slepavicius A, Eismontas V, Kybransiene M, Dulskas A, Kuliavas J, Kavaliauskas P, Kavaliauskaite R, Poškus E, Danys D, KryŽauskas M, Mikalauskas S, Rackauskas R, Drungilas M, Poškus T, Jotautas V, Strupas K, Cachia C, Cefai C, Portelli L, Youssef Y, Degaetano D, Debono S, Sammut M, Cassar J, Sammut K, Looyen R, Dalen ASHM, Becker MAJ, Comert D, Molder L, Tromp J, Matthee E, Tissen YM, Brinkhuis E, Vries HS, 't Hart E, Beckers K, Bekker Y, Kakar S, Doesschate SFH, Smaalen TC, Veen OC, Dingemans SA, Brink LC, Vijgen GHEJ, Voort EMF, Pool A, Rest KLC, Haak T, Sluijpers NRF, Pruijssers SR, Molenaar CJL, Gordinou de Gouberville MC, Saleh S, Mens MA, Hoeks EM, Nieuwenhuizen S, Praag EM, Westerduin E, Smit MPCM, Lely SJ, Nasimi B, Gerdsen M, Stijns RCH, Leow TYS, Penningnieuwland G, Ruiter A, Ribbers T, Aarts CAM, Tulek MS, Jonge J, Kocak S, Alqethami HJ, Constansia R, Elst PC, Tissink MW, Grüter A, Vroom Y, Voeten DM, Feenstra T, Azzahhafi J, Bofarid S, Kip M, Saleh W, Franssen S, Boon CL, Franssen RJM, Romaen I, Jense MTF, D'Souza J, Pascoe R, Scott A, Stark E, Mulholland K, Lau WK, Smith B, Adams SIB, Shah N, Ling E, Young J, Peng SL, Jacobson A, Macfater H, Farik S, Chen SY, Kilpatrick K, Kim DH, Dixon S, Yassaie S, Welman D, Coulter J, Morreau M, Li E, Rankin A, Winders J, Skipworth C, Fagan PVB, Stanfield B, 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R, Walsh L, Yu N, Rana N, Massie E, Ng J, Jung M, Lee YD, Harris M, White S, Delibegovic S, Boev B, Tonchev P, Prochazka V, Örhalmi J, Riško J, Skalický A, Chrz K, Ravn S, Ojakäär A, Duchalais E, Dörr-Harim C, Herrle F, Koutserimpas C, Giraudo G, Armellini A, Ruzzenente A, Mazzeo C, De Padua C, Realis Luc A, Maroli A, Giani I, Cufari ME, Vitali M, Ceccarelli G, Gusai GP, Quattromani R, Virgilio E, Berti S, Mulas S, Di Mola FF, Papagni V, Tuminello F, Magnoli M, Vittori L, Longheu A, Loche GA, Braccio B, De Luca E, Resta G, Ancans G, Tamosiunas A, Petrulionis M, Andrejevic P, Stellingwerf ME, Abdulrahman N, Pas KGH, Thomas G, Brandsma AM, Davids J, Rottier SJ, Roy van Zuidewijn D, Hawkins R, Ong HI, Li Y, Desmond B, Winstanley J, Martins M, Rosete M, Americano M, Santos M, Frade S, Senhorinho R, Peixoto R, Alagoa João A, Alves-Vale C, Lamas M, O'Connor DB, Hoo M, Gopaul A, Scanlon K, O'Dwyer N, Negoi I, Jovanović M, Panyko A, De Lima H, Van Vuuren S, Curchod P, Gaspar S, Imadalou L, Mutlu D, Akyol C, Uygur FA, Eray IC, Biyiklioglu O, Çetin MF, Isik AE, Karip B, Dogan H, Sarıgül L, Tunc E, Aydin T, Bodur S, Karabulut K, Francis AA, Al-hadithi A, To N, Lau ISF, Smith E, Mahapatra S, McAuliffe O, Francis AA, Imam L, Akram B, Hossaini S, Davies R, Ko M, Collins J, Pandya A, Reilly S, Archer J, Auty C, Roche CD, Livie J, Chaudhry FA, Ntakomyti E, Diallo R, Bylinski T, Wright J, Lawday S, Masiha E, Tung J, Shirazi B, Neilson A, Epton S, Patel N, Trussell S, Couldrey A, Donnelly C, Eftychiou S. Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery. Br J Surg 2020; 107:e161-e169. [PMID: 31595986 DOI: 10.1002/bjs.11326] [Show More Authors] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/06/2019] [Accepted: 07/04/2019] [Indexed: 02/05/2023]
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 (54·9 per cent men). Some 1153 (27·7 per cent) received NSAIDs on postoperative days 1-3, of whom 1061 (92·0 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 (4·6 versus 4·8 days; hazard ratio 1·04, 95 per cent c.i. 0·96 to 1·12; P = 0·360). There were no significant differences in anastomotic leak rate (5·4 versus 4·6 per cent; P = 0·349) or acute kidney injury (14·3 versus 13·8 per cent; P = 0·666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35·3 versus 56·7 per cent; P < 0·001). CONCLUSION NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement.
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