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


CONCLUSIONS
Patients on steroids have a higher incidence of postoperative complications after elective left-sided colorectal resection with rectal anastomosis.
Trésallet
Christophe
C
Department of General and Digestive Surgery, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie (Paris VI), 75651 Paris Cedex 13, France. christophe.tresallet@psl.aphp.fr
Royer
Benoit
B
Godiris-Petit
Gaëlle
G
Menegaux
Fabrice
F
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects*; D000368:Aged; D000704:Analysis of Variance; D000714:Anastomosis, Surgical; D000925:Anticoagulants / Q000008:administration & dosage; D001803:Blood Transfusion; D002908:Chronic Disease; D003082:Colectomy / Q000009:adverse effects / Q000401:mortality; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D016737:Proctocolectomy, Restorative / Q000009:adverse effects / Q000401:mortality; D012007:Rectum / Q000601:surgery*; D012131:Respiratory Insufficiency; D012189:Retrospective Studies; D012307:Risk Factors
D000305:Adrenal Cortex Hormones; D000925:Anticoagulants