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Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery.
British Journal of Surgery ( IF 9.6 ) Pub Date : 2019-10-09 , DOI: 10.1002/bjs.11326 , S J Chapman , D Clerc , R Blanco-Colino , A Otto , D Nepogodiev , G Pagano , V Schaeff , A Soares , G Zaffaroni , R Žebrák , J Hodson , R Blanco-Colino , S J Chapman , J C Glasbey , P Pata , G Pellino , A Sgrò , A Soares , T 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 Žebrák , R Paramasivam , A Martensen , H M Larsen , L Rädeker , P E Frey , A Kechagias , A Venara , E Duchalais , A Ioannidis , F Pata , G Pellino , S Pasquali , A Sgrò , A Simioni , V Farina , M Podda , L Lorenzon , V Schaeff , A Otto , M Jakubauskas , T R Elst , M Chu , P V B Fagan , C I Wells , A Alagoa João , A Soares , J Juloski , D Clerc , C Ciubotaru , S Popescu , A Yanishev , S Lee , B B Ozkan , A Yagız Sen , M K Aktas , B E Baki , B Yüksek , J C Glasbey , S Kamarajah , K Mclean , A Borakati , I H Yasin , R A Khaw , E Mills , R Goodson , N Thakral , A D Ablett , M Adra , I Kwek , S M Khan , P Quinn , L R Manley , A Badran , A Ramjeeawon , A Campbell , H L Tan , D S Rye , N Rajaraman , J G Norman , K Vutipongsatorn , G Solomou , M Akhbari , A Ali , V Murray , D M Baker , B D Brandao , B Stainer , R Thavayogan , D Jones , O O Onafowokan , A Gharooni , N Dabab , S Carlton-Carew , G Kungwengwe , M Gabriel , E Sewart , T C Shortland , S Lawday , P Pockney , A Dawson , T Arthur , C D Brumfitt , P Stewart , B Ng , J K Luong , S Delibegovic , V Ivanov , A Borisova , V Neykov , K Kunčarová , B Kološová , T Antonova , M Farkašová , R Žebrák , J L Harbjerg , S Brandsborg , S Brinck , M D Kjaer , A Mark-Christensen , K P Unbehaun , P Dalsgaard , K D Lycke , A Kechagias , P LeNaoures , E Duchalais , C Brigand , E Dumange , M Gout , C Moehwald , M Prem , O Alhalabi , S Sliwinski , J Krupp , E Gablenz , L Schmitzer , A Kopp , J Steinle , J Gsenger , L J Pohl , M Riccardi , I M Christodoulou , M Konstantinidis , N Machairas , A Zoikas , D Balalis , D K Manatakis , M L Aguilera , A Sgrò , A Simioni , L Marano , F Fleres , F Lovisetto , D Sasia , E Segalini , G Pata , A Lucchi , A Sagnotta , T Campagnaro , F Petrelli , G Gallo , M Papandrea , V Testa , G Sinibaldi , F Di Candido , F Colombo , G Perrone , S Aresu , A Biancafarina , G Canonico , M Pagnanelli , G Curletti , R Bini , A Manzoni Garberini , H Impellizzeri , N Cillara , R Tutino , A Picciariello , D Coletta , G Savino , F Ferrara , N Tamini , G Talamo , D Parini , P Giamundo , A lo Conte , G Pagano , V Ripetti , A Pesce , N Menduni , G Pellino , R Giudicissi , M Podda , E Goldin , D Rega , A Belli , V Andriola , L Gordini , F Pata , C Foppa , G Piccolo , A Birindelli , C Ferrari , Z Ballarini , F Tirelli , M Milone , M De Rosa , N S Pipitone Federico , B Molteni , P L Tilocca , G Sancini , G N Piozzi , A Lauretta , G Poillucci , S Mulas , V Schaeff , A Otto , M Jakubauskas , D Simcikas , L Portelli , J W M Wijnbergen , T L Dinger , S F H Doesschate , A S H M Dalen , D D Bos , M Hansmann , J Medina Feliz , S Z Kuiper , Z Abdulrahman , S R Pruijssers , S Farik , B M Elliott , V P Geneta , M Chu , S Wilton , H Kandelaki , S L Peng , S Campbell , Y K Lim , S S Yassaie , M Murray , P V B Fagan , C Haran , J Tan , J Castro , A Laranjeira , S Catarino , C Neves-Marques , J G Correia , B N Vieira , A C Quintela , M L Serra , J Maciel , M Cunha , D J Aparício , J Neves , J Azevedo , M Romano , F Eiró , J Romano , C Monteiro , M Claro , M R Almeida , M Peyroteo , N D Machado , H Capote , M Ferreira , X Sousa , H Devesa , D Cavadas , I Guerreiro , M Costa , M Salman , C English , N Mohammed , S Popescu , A Yanishev , A Litvin , V V Ćuk , K Mészárosová , S Van Straten , R Jaich , H De Lima , S Brooks , M Marx , M Nshalati Salvation , D Clerc , B Blaser , G Piazza , B Gagliardi , H Serin , A Yagız Sen , S S Yurdaor , M K Aktas , E Arslan , O Kopac , A Uyanik , B B Ozmen , E Tiftik , B Aksoy , A Yalcinkaya , F Ozoglu , M D Kocer , G Bilicen , E N Cinar , Ö Uslu , Y Kaya , J Wong , M M H Farhan-Alanie , G Suresh , A Asif , B J Finch , Y Bhahirathan , J Herron , Z Yi Tew , R Obukofe , C Russell , I Suchett-Kay , T Netke , L Williams , A Kisiel , F Y Liu , H Claireaux , P James , A Mondal , R Kalderon , H H Nadama , Z Al-Saraff , J P H Tam , A Powell-Chandler , F Wood , A Campbell , Rebecca Gorgievska , A Ragavoodoo , C Thakrar , D Rojoa , C Palmer , K Davidson , L Giacci , J Hale , F W Gan , R Makin-Taylor , C Y Hey , C Toh , J M Findlay , N Griffiths , S Ganesananthan , S Jasionowska , M Poustie , C Wong , T Turner , W Pyc , W Sloper , C Warner , J Coey , D Mason , S Sait , M Kowal , T C Shortland , M Owen , A Saiyed , I Ashworth , K Akbari , M Curran , P Martin , D Parker , A Dawson , K Kwok , C Lye , P Pockney , M Ghaly , T Sammour , D Lewis , R Mundasad , A Wilkes , G Ctercteko , P Stewart , S Delibegovic , S Maslyankov , R Dimov , S Iliev , D Dimitrov , F Marek , J Örhalmi , P Skalický , T Skalický , K Chrz , P Christensen , J Worsøe , E S Kristensen , K J Emmertsen , U S Loeve , E Duchalais , A L Mihaljevic , F Herrle , K M Konstantinidis , D K Manatakis , D Korkolis , I Karanikas , M L Aguilera , L Vincenti , G Anania , F Borghi , F Agresta , I Maretto , A Parisi , L Bucci , G De Palma , A Guglielmi , E Cucinotta , F La Torre , F Cianchi , M Guerrieri , A Lauretta , M Trompetto , R Persiani , G Micheletto , D Rega , A Belli , S Cantafio , F Lovisetto , M Ronconi , P A G Bisagni , M De Prizio , N Tamini , G Sinibaldi , A Franceschi , R Galleano , M Cavallini , A Brescia , L D'Ambra , A Benevento , P Niolu , M Calgaro , E Colangelo , T Grottola , D F Altomare , S Puleo , G Salamone , A Pietrabissa , G Poggioli , V Ripetti , E Erdas , R Ottonello , G Canonico , V Tonini , F Selvaggi , G Sammarco , G Ceccarelli , C De Nisco , D Surgo , L Taglietti , A Ozolins , A Sivinš , T Poskus , J Psaila , W A Bemelman , L J Graat , B Langenhoff , B P L Wijnhoven , A H 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Deksnis , O Bauermeister Potts , T Slimbajevs , N E Samalavicius , D Simcikas , V Nutautiene , P Zeromskas , J Jurgaitis , O Aliosin , A Slepavicius , V Eismontas , M Kybransiene , A Dulskas , J Kuliavas , P Kavaliauskas , R Kavaliauskaite , E Poškus , D Danys , M KryŽauskas , S Mikalauskas , R Rackauskas , M Drungilas , T Poškus , V Jotautas , K Strupas , C Cachia , C Cefai , L Portelli , Y Youssef , D Degaetano , S Debono , M Sammut , J Cassar , K Sammut , R Looyen , A S H M Dalen , M A J Becker , D Comert , L Molder , J Tromp , E Matthee , Y M Tissen , E Brinkhuis , H S Vries , E 't Hart , K Beckers , Y Bekker , S Kakar , S F H Doesschate , T C Smaalen , O C Veen , S A Dingemans , L C Brink , G H E J Vijgen , E M F Voort , A Pool , K L C Rest , T Haak , N R F Sluijpers , S R Pruijssers , C J L Molenaar , M C Gordinou de Gouberville , S Saleh , M A Mens , E M Hoeks , S Nieuwenhuizen , E M Praag , E Westerduin , M P C M Smit , S J Lely , B Nasimi , M Gerdsen , R C H Stijns , T Y S Leow , G Penningnieuwland , A Ruiter , T Ribbers , C A M Aarts , M S Tulek , J Jonge , S Kocak , H J Alqethami , R Constansia , P C Elst , M W Tissink , A Grüter , Y Vroom , D M Voeten , T Feenstra , J Azzahhafi , S Bofarid , M Kip , W Saleh , S Franssen , C L Boon , R J M Franssen , I Romaen , M T F Jense , J D'Souza , R Pascoe , A Scott , E Stark , K Mulholland , W K Lau , B Smith , S I B Adams , N Shah , E Ling , J Young , S L Peng , A Jacobson , H Macfater , S Farik , S Y Chen , K Kilpatrick , D H Kim , S Dixon , S Yassaie , D Welman , J Coulter , M Morreau , E Li , A Rankin , J Winders , C Skipworth , P V B Fagan , B Stanfield , N Henderson , A Chuang , L Maskill , H Ker , S J P McLaughlin , J Kearney , S Wilton , H Sprosen , P Kerckhoffs , R Alsadat , R Cherry , D A Chapman , N Singh , A Clucas , G Gatenby , B Kelly , P Ruppeldt , N D McIntosh , S Koh , H Wilms , F Dalzell , J Tewhaiti-Smith , T Kader , S T Yam , D Dahya , M Hardie Boys , W Fleischl , J Tan , A Skavysh , K 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Jardim , S P Domingos , J M Baião , B S Rocha , N M R O Lopes , D M Jordão , J G Correia , M D Ângelo , T Caroço , M Romano , J R Gomes , R G Monteiro , S Varghese , E Boyle , L Aljohmani , J Alexander , V Graziadei , C McCaughey , A Jain , J Lee , H Ramanayake , R Sabnani , L F Colon , N Bansal , I Stephens , R Tan , S Sharma , G Doherty , S Fenn , E Mulhare , M Walsh , C Leavey , O Costigan , S Griffin , é Dockry , E Khogali , A K Aly , R McPhedran , D O'Gorman , D Vermeulen , L Dervan , S J Kang , O Dixon , E Morrissey , M Compton , A R Pentony , C L Piong , R Nossier , J Hanna , K Sabir , S Y Eow , N Ladak , D Boersma , P J Kamath , T B W Soh , A H Dyer , S Y Chee , I X H Tan , A Kelliher , L Adeusi , N Howarth , N McCawley , A O'Neill , M R Jones , R Saleh , A Singh , R Senaratne , P Kakodkar , I Subramanian , A Hogan , A Al-Salihi , V Vyas , A Vedadi , S S Popescu , K Piras , C I Ciubotaru , A Litvin , E Romanova , N Ponomarev , A Savchenko , A Yanishev , R Luzan , E Lutovinova , 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, B Aksoy , B Mollavelioglu , D Gereklioglu , M Guler , S Toprak , H B Afsar , S E Guler , E Alizade , B E Baki , G Alemdag , M Ulusahin , E Arslan , E B Gul , R Yildirim , A Semiz , G Bektur , K Tomas , G Bilicen , E Yarenci , Y Demiroglu , A Sunal , B Baykan , H Abbasguliyev , V Mutlu , Y Mahmoudi , S A A Dossa , S R Mizan , B Demirtas , T Cavus , A Yuksek , S S Mazlum , C Yelkenci , T Baran , M Satilmisoglu , A Z Sahin , A Kilinç , K Isik , Ö Yumurtaci , A Emin , Çagri Girit , M K Yildirak , E Senyigit , A Güldag , B Söyleyici , Y E Aytin , F E Akay , N G Iskan , B Mutlu , A O Sunay , A D Ablett , T Tie-Gill , G Ramsay , L De Paola , S McGuckin , A Alshakhs , A Ahmeidat , J Wong , N Goergen , Z Ali , L Mullarkey , M F Bath , R Walshe , E Lewis , B Berry , J Moneim , S Mookerjee , S Christy , O Ojofeitimi , L Carroll , A Hylands , L P Delaugere , D Reveendran , C Coulter , C Ralston , L Laverty , P Gallagher , A Ahmed , Y Q Yeo , D Elliott , J Bennett , M Mcnamara , S Sivarajah , C Dunmore , G Aitken , M Nair , M H Aly , M Buari , M M H Farhan-Alanie , K Ahmed , Z Sheikh , M Monks , J Lehmann , O Rotimi , T Bell , D Limnatitou , S Gormley , P Taleongpong , V Patel , L Macgregor , S Amini , C Turner , L Dwyer-Hemmings , A Busuttil , J Powell , C Hensher , F Vivian , K Wcislo , Z Millar , S Hirosue , I Ogunmwonyi , D Nakakande , I Kwek , H Gaze , A Nirmalanantha , A M Bin Amran , A Foulkes , N Jones , S Pillai , G Khoury , T Powell , I Maleyko , A Sangheli , M Ransome , M Isse , O Aromolaran , H Bholah , J Anbarasan , S Rehman , E Hu , S Timms , W Reynolds , A Hotchkies , V Misra , G Suresh , V Murray , L Theocharidou , T Malik , I Janmohamed , B Carhart , A Khan , A Asif , R Hullait , P Quinn , A Rylance , S Butt , J Leathes , B J Finch , T Philip Rajathasan , H Jeddy , H A Kyaw , N Wong , S Karelia , J M Clements , M Rainey , N Joshi , A Rahman , M Gallagher , N Rebuffa , R Abdelgalil , R Siaw Yen Lai , N Laurence , S Thomas , C Green , R Frostick , R Khera , M 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T H Mihailidis , H Alawattegama , E Seite , A Barrett , E Riordan , W Lam , M Dowdeswell , C Mulvenna , T Netke , O Awokoya , L Gurowich , K Dhera , S Hayat , L Williams , L Tincknell , M Spazzapan , F Teeling , K Sysum , J Latter , M Latter , S Khan , M Guruswamy , W Beedham , E Brazier , M Elghobashy , M Bajaj , H Mann , E Etel , M Woodmass , H Hayden , A Kisiel , Y Ali , S Husain , A Arnold , A C Pedersen , P Cunha , M Ahmed , S Al Zawawi , V Kudva , F Y Liu , K Theodoropoulou , M Miscampbell , A V Robinson , J Johnston , A Dharni , S Lamb , T Westerman , E Evans , L Campbell , M Gillespie , C M Cheong , K Kulathevanayagam , A Varghese , S I Ike , T S M Chu , B Baljer , J A W Mogg , P Rai , H A Claireaux , M Williams , R Smillie , J Goetz , E Appleby , T Fadipe , S Vaughan-Burleigh , G Puri , P Hussain , P James , R Flather , A Cutler , S Pathak , J Sheldon , T Collicott , M al-Ausi , A Mondal , A Jovaisaite , S M Shah , N Khalid , D Gutmann , S Davison , Y J Alame , L Syed , W J Owen , S D Ahsan , R Kalderon , U Anthony-Uzoeto , C Macleod Hall , S Zheng , K Wynter , C James , D Sapre , R Ghosh , J Baird , L Cockburn , O Blackwood , H H Nadama , W Simpson , S Jeong , S Bishop , R Bate , C Hobson , A H Adam , C Redclift , J Do , O Adeleye , F Poli , A Batterham , S Brown , J N Parekh , W Clay , K Pieri , A Jackson , S Brown , A Saxena , B Gurung , T Oyebola , F O'Brien , B Djeugam , S Gardezi , S Ul-Hasan , M P Martin-Hernandez , M Sisley , S Modi , R Antakia , A Elbayouk , Y J Soh , J Mather , Z Yusuf , Z Al-Sarraf , M Naja , S B Rassool , J Convill , Y Nikookam , A Warsame , J P H Tam , C Pace , M Kiandee , R Ridwan , C Carey , F Hirri , M J A McMillan , J J Ling , A Powell-Chandler , L Pendelbury , K Kerimzade , A Tang , E O Howard , S Humayun , O J Wadsworth , K Tan , F Abdelhameed , C Haglund , I Radnaeva , N Hu , S Rambhatla , D Waldron , P Madahar , S Malik , A Campbell , L C Meney , I Ibrahim , C K Kang , J Z J Chiu , V Livie , B Ibrahim , M Khalil , G Pooley , B Shishkin , R Gorgievska , J Docherty , A Southgate , A Coomes , F McGee , S Flanagan , C Thakrar , Q J Tan , H Anwar , R Clough , B Chrisp , J Cassels , G W V Cross , A Ragavoodoo , L Mercer , C Mercer , A Refalo , R Hadley , A McTighe , F Farrow , A Brodie , G Davis , D R Shah , C Bowers , S Patel , O Morice , A Burzic , J Cheung , A Shashidhara , G Theodoraki , J Birk , A Ong , M P E Ng , R T W Wong , S Maese , B Yeap , Z Iqbal , D M Rojoa , C Cabaleiro Barciela , M Hussain , C M Ruddy , S Lindwe , Y Qamar , S Chuita , T Melaugh , J D Hall , C Palmer , O Kouli , A S I Hassane , A W Azhar , T K Tan , W Perchard , T Scurr , K Davidson , E Campbell , L Kelk , A Ghosh , A Gibbins , D Mala , A Loizidou , O Hall , L Mecia , C Hew , K Varathan , L Tong , B Chandrasekar , L Giacci , E Buchanan , M O'Connell , S Y Kwak , E H Ong , S Gardner , J Lim , C Maden , M Illahi , J Hale , Z Xuan Tan , S Edwards , R Stahl , J Stahl , A Hickman , D Collett , Z Goolam-Mahomed , B Allen , A Atiyah , H Ahmad , J Jones , O McGregor , E Ogundiya , F W Gan , A Boulbadaoui , O Kirnon-Jackman , Q X Lim , H Peckham , T Yeoh , S Q Yong , J Y Chen , S Siva , Z H Sam , M Gilani , Y N Goh , M G Muthukumar , S Phillips , R Makin-Taylor , J Tjoakarfa , A Giri , S Suresan , R Thavayogan , C Y Hey , P Thomas , T A Johnson , R I Williams , A Rashid , A Kushairi , A Rais , A James , M Bugelli , Y Chechelnitskaya , N Sandhu , C Toh , R Tandon , M Gray , A Kumar , C Ciurleo , I Nyamali , S Hiremath , S Sinha , M Chowdhary , E Bradley , M McTiernan , S Macdonald , S Sharkey , N McLaughlin , C Amey , L Kraria , O Skan , C Kind , J M Findlay , P Tupper , C Van Rhee , S I Honeyman , G Menon , M Ahmed , L Jegatheeswaran , N Griffiths , A Madhavan , M Warne , F L Malcolm , T Lessware , H T Wilkerson , S Chatterjee-Woolman , A Yoong , W U R Ahmed , A Longshaw , O Flannery , R Green , M Leaning , J Cragg , H Sharriff , C Doherty , S Ganesananthan , K W L Kwan , L Sanders-Crook , S Bhatia , S Eames , F Lewis , P Kirupananthan , Z Y Boh , S Dass , A Soma , A Newton , M Hill , Y Shafiq , M Brkljac , L Boyce , S Jasionowska , W J English , S Lam , C Chipeta , D Yilmaz , C Jain , T Garofalidou , S A Novotny , S Locke , C Bowman , A Begaj , C Murphy , K Radcliffe , J T Chong , M Poustie , E Jeffrey , N Chaudhury , K Rajendran , Z Akbar , B Walters , B Kulendrarajah , N Tran , S Shrestha , S Parmar , C Gallagher , L Hennessy , E Pentti , S Badhrinarayanan , A Fung , M Mansoor , R Kenny , P Kan , D E Lee , S Khosla , M Samake , F Shaban , R Aftab , M Gough , B Woodburn , S Vayalapra , K McMurrugh , C Wong , D Jimulia , S Deol , S Pike , Y Embury-Young , T Turner , M Patel , E Kilgallon , R Keating , A Walsh , H Khan , G Logue , M Orekoya , M Alasmar , M Charalambides , A Clavé Llavall , E Williamson , Y Bharwada , S Zearmal , H Evans , M Panikkar , G Cruz , J Caplan , A Ruparelia , T Tanvir , C Soare , Y L Pang , J Trotter , A Zaidi , V Thakrar , P Pulickal , H Ahmed , J Parnell , H Khan , S Lennock , V Ford , W Pyc , R Brignall , D O'Neill , R Hanna , R Kane , M Nicola , K Rajput , Y Xiao , C Warner , S Michael , E Wright , S Juniper , E Thompson , L Hoskyns , A Kanitkar , C Ross , A Unsworth , H Rshaidat , K Demarre , A Chiang , A Bareh , J Dellen , C Faqihinejad , A Gadhvi , R Grant , J Lewsey , A Morris , H Martin , C McClarty , S Sanyal , A Alsaif , A Palkhi , S Bhopal , S Vishnu K , A Papanikolaou , A Mitra , A Nur , F Ali , C Burford , T Huq , W Sloper , E Irwin , L Matthews , W S Ngu , T Hosfield , F Muneeb , O Page , E Zeb , J Coey , A Al-Azzawi , J McIntosh , A Vucicevic , M Hughes , L Brooks , B Fanibi , M Dixon , P Njoku , D Morris , J Jobson , H Chowdhury , D O T Alawode , W Wynell-Mayow , V Udayachandran , D Alsoof , J Ekert , N Joseph , N Zulkefley , G Hunt , T Christodoulou , O Wright , S Soman , M Jamal , S Beqiri , P Borgas , S Christie , F Pereira , S Browne , J Yiu , A Dworkin , J Brayley , A Palmer , M Charalambos , C J Jones , S Toner , R Cowden , L Lee , P Nicol , O Holman , M Imtiaz , V Albert , S P Leung , M Erotocritou , J Wong , R Stroud , D Mason , R Wilkin , W Thomson , L Mackee , N G , Y Bei , S Sait , S Mckenna Favier , A Ibrahim , A Kler , L Reynolds , S H Mohamed , Y Majeed , B Fakim , A Jones , M Kowal , G Liversedge , Z Carrington , J Windebank , A Izzarina , U Akbani , J Craven , A Aldarragi , S Harding , A Millward , T C Shortland , M Bedford , R Stroud , R Obukofe , E Mackenzie , V Gopalan , A Midgen , P Khadka , O Cheng , S Taneja , N Manobharath , J Y Kok , D W E Lim , T Buick , M Boland , S Piya , R Devlin , C J Fairfield , R J George , M Rahi , S Zaman , S Hajiev , T Ross , M Owen , E Crisp , C Thompson , A Charalambous , J L Hollywood , A Saiyed , R F L Hammond , J Matthews , V Mendonca , J Spinty , K Khan , J Cheng , N Glynn , U Muhammad , M Khan , L Anderson , K Mccormack , J Mak , S Patrawala , N Milinkovic , R Schofield , M Chauhan , L Hartley , J Hind , I Ashworth , L Nelson , D Ratnasingham , K Akbari , T Whitehead , S Dimitriadis , K Marshall , E J Flint , M Curran , C Horner , A Heybourne , H Morgan , C Wickstone , D Panagiotou , E O'Connell , K Dean , R Iqbal , L Walsh , N Yu , N Rana , E Massie , J Ng , M Jung , Y D Lee , M Harris , S White , S Delibegovic , B Boev , P Tonchev , V Prochazka , J Örhalmi , J Riško , A Skalický , K Chrz , S Ravn , A Ojakäär , E Duchalais , C Dörr-Harim , F Herrle , C Koutserimpas , G Giraudo , A Armellini , A Ruzzenente , C Mazzeo , C De Padua , A Realis Luc , A Maroli , I Giani , M E Cufari , M Vitali , G Ceccarelli , G P Gusai , R Quattromani , E Virgilio , S Berti , S Mulas , F F Di Mola , V Papagni , F Tuminello , M Magnoli , L Vittori , A Longheu , G A Loche , B Braccio , E De Luca , G Resta , G Ancans , A Tamosiunas , M Petrulionis , P Andrejevic , M E Stellingwerf , N Abdulrahman , K G H Pas , G Thomas , A M Brandsma , J Davids , S J Rottier , D Roy van Zuidewijn , R Hawkins , H I Ong , Y Li , B Desmond , J Winstanley , M Martins , M Rosete , M Americano , M Santos , S Frade , R Senhorinho , R Peixoto , A Alagoa João , C Alves-Vale , M Lamas , D B O'Connor , M Hoo , A Gopaul , K Scanlon , N O'Dwyer , I Negoi , M Jovanović , A Panyko , H De Lima , S Van Vuuren , P Curchod , S Gaspar , L Imadalou , D Mutlu , C Akyol , F A Uygur , I C Eray , O Biyiklioglu , M F Çetin , A E Isik , B Karip , H Dogan , L Sarıgül , E Tunc , T Aydin , S Bodur , K Karabulut , A A Francis , A Al-hadithi , N To , I S F Lau , E Smith , S Mahapatra , O McAuliffe , A A Francis , L Imam , B Akram , S Hossaini , R Davies , M Ko , J Collins , A Pandya , S Reilly , J Archer , C Auty , C D Roche , J Livie , F A Chaudhry , E Ntakomyti , R Diallo , T Bylinski , J Wright , S Lawday , E Masiha , J Tung , B Shirazi , A Neilson , S Epton , N Patel , S Trussell , A Couldrey , C Donnelly , S Eftychiou , ,
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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.
ANTECEDENTES
El ileo es frecuente tras cirugía colorrectal electiva y se asocia con un incremento de los eventos adversos y de la duración de la estancia hospitalaria. El objetivo fue evaluar el papel de los fármacos antiinflamatorios no esteroideos (non-steroidal anti-inflammatory drugs, NSAIDs) para reducir el ileo tras la cirugía. MÉTODOS: Estudio de cohortes prospectivo y multicéntrico efecuado por un grupo colaborativo dirigido por estudiantes y cirujanos en formación. Se incluyeron pacientes adultos sometidos a cirugía colorectal electiva entre enero y abril 2018. El resultado primario fue el tiempo hasta la recuperaciòn gastrointestinal, medido por una variable compuesta de función intestinal y tolerancia a la alimentación oral. El impacto de los NSAIDs se exploró utilizando un análisis de regresión de Cox, que incluía los resultados de una encuesta específica dirigida a los centros sobre la adherencia a los principios de la recuperación intensificada. Los resultados secundarios de seguridad incluyeron la dehiscencia anastomótica y la insuficiencia renal aguda.
RESULTADOS
Se incluyeron 4.164 pacientes con una mediana de edad de 68 años (rango intercuartílico: 57-75; 54,9% varones). Un total de 1.153 (27,7%) pacientes fueron tratados con NSAIDs en los días postoperarorios 1-3, de los cuales 1.061 (92,0%) recibieron inhibidores no selectivos de la ciclooxigenasa. Tras los ajustes por las diferencias basales, el tiempo medio hasta la recuperación gastrointestinal no difería significativamente entre pacientes que recibieron o no recibieron NSAIDs (4,6 versus 4,8 días; cociente de riesgos instantáneos, hazard ratio, HR 1,04, i.c. del 95%: 0,96-1,12, P = 0,360). No hubo diferencias significativas en la tasa de dehiscencias anastomóticas (5,4% versus 4,6%; P = 0,349) o insuficiencia renal aguda (14,3% versus 13,8%; P = 0,666) entre los grupos. Sin embargo, significativamente menos pacientes de los que recibieron NSAIDs precisaron una analgesia intensa con opioides (35,3% versus 56,7%; P < 0,001). CONCLUSIÓN: La administración de NSAIDs no redujo el tiempo hasta la recuperación gastrointestinal tras cirugía colorrectal, pero fueron seguros y se asociaron con una reducción en la necesidad de opioides postoperarorios.
中文翻译：
非甾体抗炎药减少结直肠手术后肠梗阻的安全性和有效性。
背景 肠梗阻在择期结直肠手术后很常见，并且与不良事件增加和住院时间延长有关。目的是评估非甾体抗炎药 (NSAID) 在减少术后肠梗阻方面的作用。方法 一项前瞻性多中心队列研究由一个国际、学生和实习生领导的合作小组进行。纳入了 2018 年 1 月至 2018 年 4 月期间接受择期结直肠切除术的成年患者。主要结果是胃肠道恢复的时间，使用肠功能和口服耐受性的综合测量方法进行测量。使用 Cox 回归分析探讨了非甾体抗炎药的影响，包括针对增强康复原则的特定中心调查的结果。次要安全结果包括吻合口漏率和急性肾损伤。结果 共纳入 4164 名患者，中位年龄为 68（iqr 57-75）岁（54·9% 为男性）。大约 1153 人（27·7%）在术后第 1-3 天接受了非甾体抗炎药，其中 1061 人（92·0%）接受了非选择性环加氧酶抑制剂。校正基线差异后，接受非甾体抗炎药和未接受非甾体抗炎药的患者胃肠道恢复的平均时间没有显着差异（4·6 天 vs 4·8 天；风险比 1·04，95% ci 0·96 到1·12；P = 0·360)。两组间吻合口漏率（5·4 对 4·6%；P = 0·349）或急性肾损伤（14·3 对 13·8%；P = 0·666）没有显着差异. 接受 NSAIDs 的患者需要强效阿片类镇痛药的人数明显减少（35·3 对 56·7%；P < 0·001）。结论 非甾体抗炎药并未缩短结直肠手术后胃肠道恢复的时间，但它们是安全的，并且与术后阿片类药物需求的减少有关。前身 El ileo es frecuente tras cirugía colorrectal ectiva y se associa con un incremento de los eventos adversos y de la duración de la estancia hospitalaria。El objetivo fue evaluar el papel de los fármacos antiinflamatorios noesteroideos（非甾体抗炎药，NSAIDs）para reducir el ileo tras la cirugía。MÉTODOS: Estudio de crowdes prosspective y multicéntrico efecuado por un grupo colaborativo dirigido por estudiantes y cirujanos en formación。Se incluyeron pacientes sometidos a cirugía colorectal Electiva entre enero y abril 2018. El resultado primario fue el tiempo hasta la recueraciòn 食道，medido por una variable compuesta de función gut y tolerancia a la alimentación oral。El Impacto de los NSAIDs se exploró utilizando un análisis de regresión de Cox, que incluía los resultados de una encuesta específica dirigida a los centros sobre la adherencia a los principios de la recueración intensificada。Los resultados secundarios de seguridad incluyeron la dehiscencia anastomótica y la insuficiencia 肾 aguda。结果 Se incluyeron 4.164 pacientes con una mediana de edad de 68 años (rango intercuartílico: 57-75; 54,9% varones)。Un total de 1.153 (27,7%) pacientes fueron tratados con NSAIDs en los días postoperarorios 1-3, de los cuales 1.061 (92, 0%) recibieron inhibidores no selectivos de la ciclooxigenasa。Tras los ajustes por las diferencias basales, el tiempo medio hasta la recuperación 胃肠道 no difería significativamente entre pacientes que recibieron o no recibieron NSAIDs (4,6 vs 4,8 días; cociente de riesgos instantáneos, 危险比, HR 1,04, ic德尔 95%：0,96-1,12，P = 0,360）。No hubo diferencias significativas en la tasa de dehiscencias anastomóticas (5,4% vs 4,6%; P = 0,349) o insuficiencia aguda (14,3% vs 13,8%; P = 0,666) entre los grupos。Sin embargo,significativamente menos pacientes de los que recibieron NSAIDs precisaron una analgesia intensa con opioides (35,3% vs 56,7%; P < 0,001)。结论：La administración de NSAIDs no redujo el tiempo hasta la recuperación 胃肠道 tras cirugía colorrectal，
更新日期：2019-10-10
中文翻译：
非甾体抗炎药减少结直肠手术后肠梗阻的安全性和有效性。
背景 肠梗阻在择期结直肠手术后很常见，并且与不良事件增加和住院时间延长有关。目的是评估非甾体抗炎药 (NSAID) 在减少术后肠梗阻方面的作用。方法 一项前瞻性多中心队列研究由一个国际、学生和实习生领导的合作小组进行。纳入了 2018 年 1 月至 2018 年 4 月期间接受择期结直肠切除术的成年患者。主要结果是胃肠道恢复的时间，使用肠功能和口服耐受性的综合测量方法进行测量。使用 Cox 回归分析探讨了非甾体抗炎药的影响，包括针对增强康复原则的特定中心调查的结果。次要安全结果包括吻合口漏率和急性肾损伤。结果 共纳入 4164 名患者，中位年龄为 68（iqr 57-75）岁（54·9% 为男性）。大约 1153 人（27·7%）在术后第 1-3 天接受了非甾体抗炎药，其中 1061 人（92·0%）接受了非选择性环加氧酶抑制剂。校正基线差异后，接受非甾体抗炎药和未接受非甾体抗炎药的患者胃肠道恢复的平均时间没有显着差异（4·6 天 vs 4·8 天；风险比 1·04，95% ci 0·96 到1·12；P = 0·360)。两组间吻合口漏率（5·4 对 4·6%；P = 0·349）或急性肾损伤（14·3 对 13·8%；P = 0·666）没有显着差异. 接受 NSAIDs 的患者需要强效阿片类镇痛药的人数明显减少（35·3 对 56·7%；P < 0·001）。结论 非甾体抗炎药并未缩短结直肠手术后胃肠道恢复的时间，但它们是安全的，并且与术后阿片类药物需求的减少有关。前身 El ileo es frecuente tras cirugía colorrectal ectiva y se associa con un incremento de los eventos adversos y de la duración de la estancia hospitalaria。El objetivo fue evaluar el papel de los fármacos antiinflamatorios noesteroideos（非甾体抗炎药，NSAIDs）para reducir el ileo tras la cirugía。MÉTODOS: Estudio de crowdes prosspective y multicéntrico efecuado por un grupo colaborativo dirigido por estudiantes y cirujanos en formación。Se incluyeron pacientes sometidos a cirugía colorectal Electiva entre enero y abril 2018. El resultado primario fue el tiempo hasta la recueraciòn 食道，medido por una variable compuesta de función gut y tolerancia a la alimentación oral。El Impacto de los NSAIDs se exploró utilizando un análisis de regresión de Cox, que incluía los resultados de una encuesta específica dirigida a los centros sobre la adherencia a los principios de la recueración intensificada。Los resultados secundarios de seguridad incluyeron la dehiscencia anastomótica y la insuficiencia 肾 aguda。结果 Se incluyeron 4.164 pacientes con una mediana de edad de 68 años (rango intercuartílico: 57-75; 54,9% varones)。Un total de 1.153 (27,7%) pacientes fueron tratados con NSAIDs en los días postoperarorios 1-3, de los cuales 1.061 (92, 0%) recibieron inhibidores no selectivos de la ciclooxigenasa。Tras los ajustes por las diferencias basales, el tiempo medio hasta la recuperación 胃肠道 no difería significativamente entre pacientes que recibieron o no recibieron NSAIDs (4,6 vs 4,8 días; cociente de riesgos instantáneos, 危险比, HR 1,04, ic德尔 95%：0,96-1,12，P = 0,360）。No hubo diferencias significativas en la tasa de dehiscencias anastomóticas (5,4% vs 4,6%; P = 0,349) o insuficiencia aguda (14,3% vs 13,8%; P = 0,666) entre los grupos。Sin embargo,significativamente menos pacientes de los que recibieron NSAIDs precisaron una analgesia intensa con opioides (35,3% vs 56,7%; P < 0,001)。结论：La administración de NSAIDs no redujo el tiempo hasta la recuperación 胃肠道 tras cirugía colorrectal，
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