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Br J Surg. 2019 Oct 9. doi: 10.1002/bjs.11326. [Epub ahead of print]

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

Collaborators (2842)

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, 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, 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, van Elst TR, Chu M, Fagan P, 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, de 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, van Wijnbergen J, Dinger TL, Ten Doesschate S, van Dalen A, van den 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 P, 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 M, 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 J, 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 P, 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 B, van de Ven A, Poelman M, Stassen L, Slooter G, Acherman Y, Hoff C, Gerhards MF, Stommel M, Hazebroek EJ, van Geloven A, Schasfoort RA, van Leeuwen BL, Tuynman JB, van Tilburg M, 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, Debiasio A, Wong J, Jun H, Hengpoonthana R, Mendis DM, Robb PM, Lee HJ, Wyche A, Davis LT, Lee HJ, Chrimes A, Agarwal A, Zhao J, Williams S, Jayalath J, Liebenberg P, Khor S, Muddasani T, Childs S, Ridgway S, Blefari N, Tam H, Puchalski N, Ngai C, Mackenzie J, Johnson N, Holmes M, Zuzek R, Saluja T, Gould T, Goh YK, Selvaraj T, Brumfitt CD, Beh YZ, Dudi-Venkata NN, Horne D, Borrow JL, Campbell C, Cousins G, Jackson L, Maheepala K, Zhao S, Holden E, Tutt L, Thompson B, Collins H, Louie F, Buckland B, Smith D, Chong C, Chua TH, Nayak C, Redmond J, Tan RR, Gramlick M, Teh JS, Ng SY, Britten-Jones P, Mohd Rosli R, Pham H, Jegathees T, Coulter-Nile S, Gosselink MP, Luong JK, Wang YL, Maciaszek M, Chrapko PS, Nair A, Thirugnanasundralingam V, Muir K, Salibasic M, Pavlov V, Paycheva T, Borisova A, Lyulenina E, Kolev N, Ivanov V, Nguen D, Mitkov Y, Mitkov E, Vladova P, Dimitrov V, Hussain M, Gabarski A, Ivanov T, Yotsov T, Ilieva I, Karamanliev M, Akisheva A, Shoshkova M, Nawaz E, Feradova H, Mladenov T, Neykov V, Jozaf V, Farkašová M, Klail T, Pös M, Adel A, Sotona O, Bartoš M, Amjad T, Malý O, Berec S, Hanušová M, Hurný M, Riško J, Ludvik M, Stercz M, Treskoň R, Pospíšil M, Hlaváčová L, Kunčarová K, Tomanová D, Chodora S, Houdek O, Novický R, Antonova T, Sobotková K, Cha S, Šuta Kimle K, Jirankova K, Bujda M, Paclík A, Trap A, Jürgens-Lahnstein J, Storm M, Dalsgaard P, Damgaard I, Olawi F, Ehlem F, Raos M, Kristensen FP, Lycke KD, Bønnerup K, Unbehaun KP, Kjaer MD, Brandsborg S, Amiri S, Enevoldsen M, Harbjerg JL, Højgaard Pedersen J, Jepsen BN, Hillgaard TK, Erichsen SB, Nielsen CV, Madsen CP, Bjerke J, Skejø CD, Aabling RR, Sørensen JS, Mark-Christensen A, Kechagias A, Turunen A, Katunin J, Niskakangas M, Vignaud T, Frey S, Ricolleau C, Chanut F, Magnin J, Gout M, Seiboldt T, Beck L, Pohl LJ, Zamzow K, Betge F, Poncelet A, Truant M, Hauschild H, Neugebauer N, Schöning L, Simon SC, Galata C, Karampinis I, Thäwel T, Seckler AM, Kerem C, Durdevic S, Ioannidis A, Antonakopoulos F, Konstantinidis M, Mathioulaki A, Chrysoheris P, Athanasopoulos PG, Kalles V, Spyrou I, Barkolias C, Paspala A, Machairas N, Papaconstantinou D, Spartalis E, Arkadopoulos N, Prodromidou A, Garoufalia Z, Balalis D, Zoikas A, Christodoulou IM, Mendez D, Rosales J, Flores M, Garcia M, Garcia A, Garcia M, Noriega Z, Torselli D, Aguilera ML, Rodriguez J, Lafranceschina S, Artioli E, Giaccari S, Nevoso V, Schimera A, Marino S, Geretto P, Pellegrino L, Borghi B, Sasia D, Marano A, Corino C, Cannata G, Giuffrida MC, Landra F, Pata G, Ongaro D, Baronio G, Raimondo S, Casiraghi S, Salvadori R, Savino G, Finotti E, Ciccioli E, Galgano A, Zuin M, Simioni A, Bettella A, Barina A, Vendramin E, Palano G, Schiavone D, Di Cintio A, Gemini A, Trastulli S, De Luca M, Sagnotta A, Desiderio J, Gubbiotti F, Cigognini M, Zaffaroni G, Maffioli A, Colombo S, Bondurri A, Sampietro G, Foschi D, Colombo F, Manigrasso M, Danzi M, Amato R, Anastasio L, Mastella F, Basile R, Peltrini R, Marra E, Luglio G, Pagano G, Giglio M, Manigrasso M, Anoldo P, Vertaldi S, Grimaldi L, Tammaro N, Pedrazzani C, Campagnaro T, Turri G, Lazzarini E, Conti C, Vulcano I, Bertilone E, Pintabona G, Viscosi F, Cerasari S, Galiffa G, Lapolla P, Coletta D, Del Basso C, Cirillo B, De Toma G, Fazzi K, Bini S, Coratti F, Montanelli P, Grandi S, Nelli T, Ben Khaled N, Cammelli F, Ferrini E, Billo ME, Tilocca PL, Marrosu AG, Scognamillo F, Pala C, Attene F, Carboni L, Ruggiu MW, Gabbas G, Marziali I, Mazzocato S, Petrelli F, Vergari R, Piazzai F, Kubolli I, Aggiusti A, Paolucci A, Ortenzi M, Olivieri M, Belluco C, Antona AD, Basso S, Morino M, Mistrangelo M, Testa V, Gallo G, Clerico G, De Santi G, Bitonti MF, Trompetto M, Pipitone Federico NS, Frattalone M, Tirelli F, Fico V, Santullo F, Belia F, Spinelli A, Marco M, Di Candido F, Bevilacqua M, Tringali D, Bevilacqua E, Panizzo V, Piozzi GN, La Manna V, Migliore G, Aversano A, Fares Bucci A, Marino F, Carbone F, Incollingo P, Romano FM, Giudicissi R, Zalla T, Baraghini M, Romoli L, Calussi M, Vellei S, Genzano C, Feroci F, Vita M, Barberis A, Serra D, 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P, Rosati R, Marcocci G, Vignali A, Curletti G, Galleano R, Badran A, Malerba M, Percivale A, Ghazouani O, Reggiani L, Spirito C, Moschetta G, Cosmi F, Romeo G, Gasparrini M, Sucameli F, Gennai A, Moggia E, Bianchi C, Bonfante P, Macina S, Feleppa C, Talamo G, Imperatore M, Tenconi SM, Rausei S, Maioli D, Marchionini V, Pata F, Sparta C, Mura FA, Barmina M, Lorettu A, Rettaroli C, Mastino G, Ruggiu GV, Mura GA, Perrone BA, De Angelis M, Mereu A, Adamo V, Bianco C, de Manzoni Garberini A, Ricciardiello M, Campanaro C, Panaccio P, Esposito LM, D'Ascanio F, Pietroletti R, Picciariello A, Chetta N, Aquilino F, Di Marco F, Amico A, Schembari E, Puglisi S, Licari L, Campanella S, Profita G, Falco N, Rotolo G, Venturelli P, Tutino R, De Marco P, Marcianò M, Sgrò A, Argenti F, Milani MS, Malabarba S, Giambartolomei G, Vella I, Gronchi F, Ruggieri A, Sancini G, Roggiani A, Balsamo 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, van Looyen R, van Dalen A, Becker M, Comert D, Te Molder L, Tromp J, Matthee E, Tissen YM, Brinkhuis E, de Vries HS, 't Hart E, Beckers K, Bekker Y, Kakar S, Ten Doesschate S, van Smaalen TC, Veen OC, Dingemans SA, van den Brink LC, Vijgen G, van de Voort E, van der Pool A, van Rest K, Haak T, Sluijpers N, Pruijssers SR, Molenaar C, Gordinou de Gouberville MC, Saleh S, Mens MA, Hoeks EM, Nieuwenhuizen S, van Praag EM, Westerduin E, Smit M, van der Lely SJ, Nasimi B, Gerdsen M, Stijns R, Leow T, Penningnieuwland G, de Ruiter A, Ribbers T, Aarts C, Tulek MS, de Jonge J, Kocak S, Alqethami HJ, Constansia R, van 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 R, Romaen I, Jense M, D'Souza J, Pascoe R, Scott A, Stark E, Mulholland K, Lau WK, Smith B, Adams S, 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 P, Stanfield B, Henderson N, Chuang A, Maskill L, Ker H, McLaughlin S, Kearney J, Wilton S, 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Abstract

in English, Spanish

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.

PMID:
31595986
DOI:
10.1002/bjs.11326

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