Effect of corticosteroid dose and duration of administration on colonic anastomosis

Abstract

High and low doses of the corticosteroid produced adverse effects on the healing of colon anastomosis in rats regardless of whether it was administered over a long or short preoperative period. However, the most prominent negative effect was associated with high-dose, long-term corticosteroid administration.

Treatment with corticosteroids and the risk of anastomotic leakage following lower gastrointestinal surgery: a literature survey

“…Although corticosteroids are generally thought to impair intestinal anastomotic healing, this effect has never been proven unequivocally in clinical studies . Some experimental studies have concluded that corticosteroid use impairs the healing of colonic anastomosis in a rat model , but others have reported no such effect . Baca et al .…”

“…Although corticosteroids are generally thought to impair intestinal anastomotic healing, this effect has never been proven unequivocally in clinical studies [20]. Some experimental studies have concluded that corticosteroid use impairs the healing of colonic anastomosis in a rat model [21][22][23], but others have reported no such effect [20]. Baca et al [23] conducted an experimental study to investigate how long-and short-term corticosteroid administration in high and low doses modulated the course of the healing process for colonic anastomoses.…”

“…Some experimental studies have concluded that corticosteroid use impairs the healing of colonic anastomosis in a rat model [21][22][23], but others have reported no such effect [20]. Baca et al [23] conducted an experimental study to investigate how long-and short-term corticosteroid administration in high and low doses modulated the course of the healing process for colonic anastomoses. The study indicated that high and low doses of methylprednisolone impaired the healing of colon anastomosis in rats, regardless of whether the methylprednisolone was administered over a long or a short preoperative period.…”

Reducing gastrointestinal anastomotic leak rates: review of challenges and solutions

“…38,39 Not surprisingly, long-term administration of high-dose steroids has been shown to cause the most impairment in healing. 40 In systemic analysis, steroids have been shown to increase anastomotic leak rate. 41 Muddying the waters a bit is a study on patients with inflammatory bowel disease, which demonstrated no increase in anastomotic leak in patients who are on low-and high-dose steroids at the time of surgery.…”

Detection of endogenous cortisol in equine tears and blood at rest and after simulated stress

“…Despite the beneficial anti‐inflammatory effects of corticosteroids, there are potential negative effects on corneal healing, which frequently preclude their use in equine ulcerative keratitis. Corticosteroids have been associated with a delayed repair in several nonocular tissues . Specific to ophthalmology, corticosteroids have been found to retard corneal epithelial defect closure and contribute to lower corneal stromal cell density in a dose‐dependent manner .…”