The American Journal of Surgery
Volume 195, Issue 4 , Pages 447-451, April 2008

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

Department of General and Digestive Surgery, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique–Hôpitaux de Paris (AP-HP), Université Pierre et Marie Curie (Paris VI), 47-83 Boulevard de l’Hôpital, 75651 Paris Cedex 13, France

Received 8 October 2006; received in revised form 19 February 2007 published online 28 February 2008.

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.

Keywords: Colorectal surgery, Corticosteroids, Morbidity

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PII: S0002-9610(08)00050-0

doi:10.1016/j.amjsurg.2007.02.031

The American Journal of Surgery
Volume 195, Issue 4 , Pages 447-451, April 2008