Diseases of the Colon & Rectum

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Diseases of the Colon & Rectum:
doi: 10.1097/DCR.0b013e318298252f
Original Contributions: Benign Colorectal Disease

Perioperative Statin Therapy Is Not Associated With Reduced Risk of Anastomotic Leakage After Colorectal Resection

Bisgård, Anne Sofie M.D.1; Noack, Morten Westergaard M.S.1; Klein, Mads M.D., Ph.D.1; Rosenberg, Jacob M.D., D.M.Sc.1; Gögenur, Ismail M.D., D.M.Sc.1,2

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BACKGROUND: Anastomotic leakage is a serious complication of colorectal surgery. Several studies have demonstrated the beneficial pleiotropic effects of statins, and preliminary studies have suggested that perioperative statin treatment may be associated with reduced risk of anastomotic leakage.

OBJECTIVE: We aimed to investigate whether perioperative statin therapy was associated with a reduced anastomotic leakage rate after colorectal resections with primary anastomosis.

DESIGN: The study was based on prospectively collected data from the Danish Colorectal Cancer Group and electronically registered medical records holding information on perioperative statin therapy.

SETTINGS: Data were collected from the 6 major surgical centers responsible for all elective colorectal cancer surgery in the eastern part of Denmark.

PATIENTS: We collected data on 2766 patients with electronically registered medical records who underwent resection of the colon or rectum with primary anastomosis from 2006 to 2009.

MAIN OUTCOME MEASURE: The primary outcome measured was anastomotic leakage requiring surgical intervention.

RESULTS: Five hundred eighteen patients (19%) were treated with statins perioperatively. Four hundred ninety-six patients received statins both before and after surgery. Fifty-two patients (10.5%) received high-dose statin therapy. Possible risk factors for anastomotic leakage were identified via univariate regression analyses. In subsequent multivariate analysis, perioperative statin therapy was not associated with reduced anastomotic leakage rate (OR (95% CI) 1.31 (0.84–2.05), p = 0.23). We identified intraoperative blood transfusion, rectal resection (versus colonic), male sex, and tobacco usage as risk factors for anastomotic leakage in the multivariate analysis.

LIMITATIONS: This study is limited by its observational design and missing data on comorbidities and BMI.

CONCLUSION: Perioperative statin therapy was not significantly associated with reduced anastomotic leakage rate after colorectal resection with primary anastomosis.

© 2013 The American Society of Colon and Rectal Surgeons


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