title: Efficacy and safety of low-dose celecoxib in reducing post-operative paralytic ileus after major abdominal surgery.
abstract: BACKGROUND
  A number of interventions have been used to decrease the incidence of post-operative paralytic ileus. A secondary outcome of a randomized controlled study showed that COX-2 inhibitors decreased the incidence of paralytic ileus. We sought to study a large cohort of patients undergoing major abdominal operations who were treated with a COX-2 inhibitor.
  
  
  METHODS
  This is a retrospective review of prospectively collected data. All eligible patients were given a COX-2 inhibitor--celecoxib 100 mg--twice daily starting on the day of surgery until the seventh day post-operatively or discharge, whichever was earlier. The rate of paralytic ileus was calculated and compared with historical data. Secondary outcome measures were the effect of using COX-2 inhibitors on renal function, electrolytes and haemoglobin, morbidity and leak rates.
  
  
  RESULTS
  Two hundred and fifty-two patients were treated with celecoxib; the control arm consisted of 67 historical patients. Of the 252 patients, we had complete data for 235 patients and ileus in 17 patients (7.23%) compared with 13.4% in the control group (P = 0.05). Subgroup analysis showed ileus in 5.45% of colectomy patients and 6.36% of patients who have had a colectomy and high anterior resection. There was no detriment of measured blood tests. There were leaks in two treated patients, both of whom did not require a laparotomy.
  
  
  CONCLUSIONS
  The use of low-dose COX-2 inhibitor over a short period of time decreases the paralytic ileus rates and does not cause any significant morbidity.
authors.affiliation: Department of Colorectal Surgery, Flinders Medical Center, Adelaide, South Australia, Australia.
authors.forename: Devinder P
authors.initials: DP
authors.lastname: Raju
authors.affiliation: Department of Clinical Epidemiology, Flinders Medical Center, Adelaide, South Australia, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Hakendorf
authors.affiliation: Department of Human Physiology, Flinders University, Adelaide, South Australia, Australia.
authors.forename: Marcello
authors.initials: M
authors.lastname: Costa
authors.affiliation: Department of Colorectal Surgery, Flinders Medical Center, Flinders Private Hospital, Flinders University, Adelaide, South Australia, Australia.
authors.forename: David A
authors.initials: DA
authors.lastname: Wattchow
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000209:etiology / Q000517:prevention & control; D000068579:Celecoxib / Q000008:administration & dosage* / Q000009:adverse effects; D003082:Colectomy / Q000009:adverse effects; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D007418:Intestinal Pseudo-Obstruction / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011184:Postoperative Period; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D052246:Cyclooxygenase 2 Inhibitors; D000068579:Celecoxib
keywords: celecoxib; ileus; post‐operative