Effect of systemic corticosteroids on elective left-sided colorectal resection with colorectal anastomosis

Am J Surg. 2008 Apr;195(4):447-51. doi: 10.1016/j.amjsurg.2007.02.031.

Abstract

Background: The impact of systemic steroid therapy on surgical outcome after elective left-sided colorectal resection with rectal anastomosis is not well known.

Methods: We compared 606 consecutive patients including 53 patients who were on steroids and undergoing surgery between 1995 and 2005.

Results: Postoperative mortality and anastomotic leakage rates were equivalent. The postoperative complications rate, especially infections, was higher in steroid-treated patients than in non-steroid-treated patients: 38% (20 of 53 patients) versus 25% (139 of 553 patients), respectively (P = .046). In the steroid group, univariate analysis revealed 3 significant risk factors for postoperative complications: blood transfusion, preoperative anticoagulation, and chronic respiratory failure. In a multivariate analysis, blood transfusion and chronic respiratory failure remained independent factors for postoperative complications.

Conclusion: Patients on steroids have a higher incidence of postoperative complications after elective left-sided colorectal resection with rectal anastomosis.

Publication types

  • Comparative Study

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Adrenal Cortex Hormones / adverse effects*
  • Aged
  • Analysis of Variance
  • Anastomosis, Surgical
  • Anticoagulants / administration & dosage
  • Blood Transfusion
  • Chronic Disease
  • Colectomy* / adverse effects
  • Colectomy* / mortality
  • Elective Surgical Procedures
  • Female
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology*
  • Postoperative Complications / mortality
  • Proctocolectomy, Restorative / adverse effects
  • Proctocolectomy, Restorative / mortality
  • Rectum / surgery*
  • Respiratory Insufficiency
  • Retrospective Studies
  • Risk Factors

Substances

  • Adrenal Cortex Hormones
  • Anticoagulants