Perioperative Use of Statins in Elective Colectomy

Abstract

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.

Statin therapy and postoperative short‐term mortality after rectal cancer surgery

“…Previous studies have investigated the potential impact of statin therapy on short‐term postoperative outcomes following colorectal surgery. While some have found postoperative benefits in the form of decreased complication rates, [12–14] others have not been able to demonstrate any association [15–17]. Data on statin therapy and postoperative mortality isolated to rectal resection surgery for cancer are scarce [12].…”

Systematic review of the role of biomarkers in diagnosing anastomotic leakage following colorectal surgery

“…Additionally, the timing of blood tests varied between studies that analysed systemic biomarkers, from daily to selective days. Furthermore, none of the included studies distinguished biomarker levels between colonic and rectal resections, or disease process, nor took into account medications that may alter the inflammatory response, such as statins and steroids 12,62 . Use of peritoneal drains remains a contentious issue, with some studies 63,64 showing no benefit.…”

Statin therapy and postoperative outcomes after major colorectal surgery: The available evidence is not conclusive and robust evidence synthesis may be challenging!

“…In fact, statins are thought to have anti-inflammatory effects by directly attenuating the proinflammatory cytokines including interleukin 6, interleukin 8 and tumour necrosis factor α which are released in response to surgical trauma and are inversely correlated with recovery after surgery [2,3]. There are currently six comparative studies [1,[4][5][6][7][8] (including the study by Pourlotfi et al) on the outcomes of statin vs. no statin in patients undergoing major colorectal surgery. These are one randomized controlled trial [8] and five retrospective cohort studies [1,[4][5][6][7] and include 42 114 patients (11 411 in the statin group and 30 703 in the non-statin group).…”

“…There are currently six comparative studies [1,[4][5][6][7][8] (including the study by Pourlotfi et al) on the outcomes of statin vs. no statin in patients undergoing major colorectal surgery. These are one randomized controlled trial [8] and five retrospective cohort studies [1,[4][5][6][7] and include 42 114 patients (11 411 in the statin group and 30 703 in the non-statin group). There are more patients in the statin group classed as American Society of Anesthesiologists (ASA) Grade III (risk difference [RD] 0.04, 95% CI 0.01-0.06, P = 0.01) and ASA Grade IV (RD 0.01, 95% CI 0.00-0.01, P < 0.0001) compared with the non-statin group.…”