Uso posoperatorio de antiinflamatorios no esteroidales como factor de riesgo asociado a fuga anastomótica en cirugía colorrectal
DOI:
https://doi.org/10.31790/inspilip.v6iEspecial.378Palabras clave:
Cirugía Colorrectal, AntiinAntiflamatorios no Esteroideos, No esteroidesResumen
Introducción: El manejo posquirúrgico del dolor se considera uno de los desafíos más importantes en cirugía colorrectal. Los Antiinflamatorios No Esteroidales (AINES) aún se mantienen como los fármacos de primera línea, sin embargo, nuevas evidencias sugieren una relación con complicaciones como fuga anastomótica. Objetivo: Determinar el efecto de los antiinflamatorios no esteroidales sobre las tasas de fuga anastomótica en pacientes sometidos a cirugía colorrectal. Metodología: Se efectuó una revisión sistemática y metaanálisis de estudios comparativos entre el uso de AINES versus no AINES y la ocurrencia de fuga anastomótica. Se buscó evidencia publicada entre enero del 2010 a marzo del 2022 en las bases de EMBASE, Pubmed y CINAHL. Resultados: En general, el uso de AINES se asoció a un incremento de riesgo de fuga anastomótica (OR: 1.55, IC95 %: 1.25 – 1.93, p<0.0001). Los AINES no selectivos se asoció a un aumento del riesgo de fuga anastomótica (OR: 1.75, IC95 %: 1.43– 2.14, p<0.00001). El diclofenaco se asoció con la ocurrencia de fuga anastomótica (OR: 2.64, IC95 %: 1.86 – 3.76, p<0.00001), pero, no se encontró dicha asociación con ketorolaco (OR: 1.36, IC95 %: 0.89 – 2.07, p=0.16). Conclusiones: Los AINES no selectivos parecen asociarse a un incremento en el riesgo de fuga anastomótica luego de cirugía colorrectal. La prescripción de estos fármacos debe realizarse con prudencia. Un se requiere una mayor cantidad de estudios para esclarecer si, el uso de AINES para el manejo del dolor posquirúrgico en pacientes sometidos a cirugía colorrectal es segura o no.
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