Perioperative use of statins in elective colectomy.
BACKGROUND
Statins have many beneficial effects and may attenuate the proinflammatory and metabolic stress response to surgery and consequently reduce postoperative morbidity.


OBJECTIVE
This study investigated whether perioperative use of statins improved short-term outcomes after elective colectomy.


METHODS
This study is a retrospective review of prospectively collected data.


METHODS
This study was conducted in consecutive patients undergoing elective colonic resection within an enhanced recovery program at a tertiary hospital (Manukau Surgery Centre, Middlemore Hospital, Auckland, New Zealand) from January 2005 to December 2010.


METHODS
Complications, hospital stay, and readmissions were recorded for 30 days postoperatively. Postoperative functional recovery was measured by the use of the validated Surgical Recovery Score. Serum proinflammatory cytokines were measured on postoperative day 1.


RESULTS
There were 269 patients; 86 patients were on a statin perioperatively, whereas 183 patients had no statin. Members of the statin group were older (median age, 72 vs 69 years; p = 0.021), included more men (53% vs 40%; p = 0.049), and included a higher number of patients with an ASA score of 3 (55% vs 22%; p < 0.001). Patients on statin therapy had a significantly lower number of anastomotic leaks (1% vs 7%; p = 0.031). However, there was no significant difference in total complications or median hospital stay. The 2 groups had comparable functional recovery, and there was no significant difference in serum cytokine levels.


CONCLUSIONS
This retrospective study did not analyze type, duration, or dose of statins given perioperatively.


CONCLUSIONS
Patients on perioperative statins had greater baseline perioperative risks compared with nonusers, but they achieved equivalent outcomes overall. Statin use was associated with reduced anastomotic leaks. Thus, perioperative statin use may reduce morbidity after elective colectomy, and this finding warrants further investigation.
Department of Surgery, South Auckland Clinical School, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. dr.parrysingh@gmail.com
Primal P
PP
Singh
Sanket
S
Srinivasa
Sanka
S
Bambarawana
Daniel P
DP
Lemanu
Arman A
AA
Kahokehr
Kamran
K
Zargar-Shoshtari
Andrew G
AG
Hill
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy; D003110:Colonic Neoplasms / Q000097:blood / Q000601:surgery*; D016207:Cytokines / Q000097:blood*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D019990:Perioperative Care; D011183:Postoperative Complications / Q000517:prevention & control*; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome
D016207:Cytokines; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors