Treatment with corticosteroids and the risk of anastomotic leakage following lower gastrointestinal surgery: a literature survey

Abstract

Caution should be shown in patients scheduled for lower gastrointestinal surgery with anastomosis.

Systematic review of preoperative, intraoperative and postoperative risk factors for colorectal anastomotic leaks

“…Prolonged use of corticosteroids may be a risk factor for AL, particularly when combined with other immunosuppressants or in cushingoid patients. A systematic review found an AL rate of 6·8 per cent in the corticosteroid group compared with 3·3 per cent in patients not treated with corticosteroid, but the duration and dose of treatment were heterogeneous. Infliximab alone may not alter AL risk, but in combination with other immune modulators can slow healing.…”

Preoperative, intraoperative and postoperative risk factors for anastomotic leakage after laparoscopic low anterior resection with double stapling technique anastomosis

“…Prolonged use of corticosteroids can be a risk factor for AL, particularly when combined with other immunosuppressive drugs [4850] . A recent systematic review reported that the AL rate after lower gastrointestinal surgery was 6.8% in the corticosteroid group compared with 3.3% in the noncorticosteroid group, although the duration and dose of corticosteroid treatment were heterogeneous [51] . A metaanalysis with six RCTs reported that perioperative use of nonsteroidal anti inflammatory drugs (NSAIDs) had no statistically significant effect on the AL rate [52] .…”

Risk factors for anastomotic leakage after colorectal resection: a retrospective analysis of 17 518 patients

“…The AL rate has been variably stated to be between 1% and 19% . A wide variety of factors has been suggested to contribute to the development of AL but there is no clear consensus in the literature . Many of the studies involve small numbers of patients and studies considering the impact of a limited number of factors on the AL rate risk overlooking confounding factors.…”