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Risk of anastomotic leak after NSAID use within an ERAS programme
Bakker N, Deelder JD, Richir MC, Cakir H, Doodeman HJ, Schreurs WH, Houdijk AP. Risk of anastomotic leakage with nonsteroidal anti-inflammatory drugs within an enhanced recovery program. J Gastrointest Surg. 2016 Apr;20(4):776-82.
What is already known:
Anastomotic leakage is a much feared complication after colorectal resection. The incidence is higher in low rectal resections (up to 13%) than with colonic resections (3%). It can have a profoundly negative impact on length of stay, morbidity and mortality, and possibly on longer term oncological outcome. It is thought that NSAID’s can increase this risk.
What this paper adds:
In this single centre observational study the use of diclofenac was associated with a higher rate of anastomtic leakage in both colonic and rectal resections. Interestingly the other NSAIDS – Ibuprofen and Mebutan used in this study had no association.
Chris Jones, Guildford.
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