SynthesisWorld journal of surgery2014
Postoperative nonsteroidal anti-inflammatory drugs and risk of anastomotic leak: meta-analysis of clinical and experimental studies.
Synthesis in World journal of surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 98 citations in OpenAlex.
- Treatment Effects in Randomized and Nonrandomized Studies of Pharmacological Interventions: A Meta-Analysis.JAMA network open · 2024Pooled it
- NSAID administration post colorectal surgery increases anastomotic leak rate: systematic review/meta-analysis.Surgical endoscopy · 2019Pooled it
- Efficacy of Nalbuphine with Flurbiprofen on Multimodal Analgesia with Transverse Abdominis Plane Block in Elderly Patients Undergoing Open Gastrointestinal Surgery: A Randomized, Controlled, Double-Blinded Trial.Pain research & management · 2018Trial
- Trial
- Non-steroidal Anti-inflammatory Drugs and Timing-specific Anastomotic Leak Risk Following Minimally Invasive Proctectomy: A Retrospective Cohort Study.Annals of surgical oncology · 2026Article
- Anastomotic Leak Following Colorectal Surgery.Clinics in colon and rectal surgery · 2026Review
- Perioperative nonsteroidal anti-inflammatory drugs and the risk for anastomotic leakage in patients undergoing major gastrointestinal surgery: a retrospective cohort study.BMC anesthesiology · 2025Article
- Opiranserin injection (Unafra®) as a first-in-class, non-opioid analgesic for the treatment of acute postoperative pain.Anesthesia and pain medicine · 2025Review
- Association between flurbiprofen axetil use and operative complications occurring following colorectal surgery.Experimental and therapeutic medicine · 2025Article
- Beyond the Operating Room: A Narrative Review of Enhanced Recovery Strategies in Colorectal Surgery.Cureus · 2024Review
- Perioperative Considerations for the Surgical Treatment of Crohn's Disease with Discussion on Surgical Antibiotics Practices and Impact on the Gut Microbiome.Antibiotics (Basel, Switzerland) · 2024Review
- Non-Surgical Interventions for the Prevention of Clinically Relevant Postoperative Pancreatic Fistula-A Narrative Review.Cancers · 2023Review
- Risk of NSAID-associated anastomosis leakage after colorectal surgery: a large-scale retrospective study using propensity score matching.International journal of colorectal disease · 2022Article
- Analgesic Efficacy of Nefopam as an Adjuvant in Patient-Controlled Analgesia for Acute Postoperative Pain After Laparoscopic Colorectal Cancer Surgery.Journal of clinical medicine · 2021Article
- Review of Colonic Anastomotic Leakage and Prevention Methods.Journal of clinical medicine · 2020Review
- Bowel anastomosis leakage following endometriosis surgery: an evidence based analysis of risk factors and prevention techniques.Facts, views & vision in ObGyn · 2020Review
- Scheduled intravenous acetaminophen versus nonsteroidal anti-inflammatory drugs (NSAIDs) for better short-term outcomes after esophagectomy for esophageal cancer.Surgery today · 2020Article
- How to reduce anastomotic leakage in colorectal surgery-report from German expert meeting.Langenbeck's archives of surgery · 2020Article
- The Impact of Circular Stapler Size on the Incidence of Cervical Anastomotic Stricture After Esophagectomy.World journal of surgery · 2019Article
- Pain management within an enhanced recovery program after thoracic surgery.Journal of thoracic disease · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundEnhanced recovery programs following colorectal resection recommend the use of nonsteroidal anti-inflammatory drugs (NSAIDs) as part of multimodal analgesia. The present study aimed to assess whether postoperative NSAID use increased the risk of anastomotic leak.
methodsA systematic review of published literature was performed for studies comparing anastomotic leak following NSAID administration versus control. Meta-analysis was conducted for studies in human patients and experimental animal models. The primary endpoint was anastomotic leak.
resultsThe final analysis included 8 studies in humans and 12 experimental animal studies. Use of NSAIDs was significantly associated with anastomotic leak in humans (8 studies, 4,464 patients, odds ratio [OR] 2.14; p < 0.001). This effect was seen with nonselective NSAIDs (6 studies, 3,074 patients, OR 2.37; p < 0.001), but not with selective NSAIDs (4 studies, 1,223 patients, OR 2.32; p = 0.170). There was strong evidence of selection bias from all clinical studies, with additional inconsistent definitions and outcomes assessment. From experimental animal models, anastomotic leak was more likely with NSAID use (ten studies, 575 animals, OR 9.51; p < 0.001). Bursting pressures at day 7 were significantly lower in NSAID versus controls (7 studies, 168 animals, weighted mean difference -35.7 mmHg; p < 0.001).
conclusionsEmerging data strongly suggest that postoperative NSAIDs are linked to anastomotic leak, although most studies are flawed and may be describing pre-existing selection bias. However, when combined with experimental data, these increasing concerns suggest caution is needed when prescribing NSAIDs to patients with pre-existing risk factors for leak, until more definitive evidence emerges.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.