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Preoperative beta b...
Preoperative beta blockers and other drugs in relation to anastomotic leakage after anterior resection for rectal cancer
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- Gerdin, Anders (författare)
- Umeå University,Umeå universitet,Institutionen för kirurgisk och perioperativ vetenskap,Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
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- Park, Jennifer (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery,Sahlgrenska Academy
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- Häggström, Jenny, 1980- (författare)
- Umeå University,Umeå universitet,Statistik,Department of Statistics, Umeå School of Business, Economics and Statistics, Umeå University, Umeå, Sweden
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- Segelman, Josefin (författare)
- Karolinska Institutet,Ersta Hospital
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- Matthiessen, Peter, 1957- (författare)
- Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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- Lydrup, Marie Louise (författare)
- Lund University,Lunds universitet,Kirurgi,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Surgery,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital
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- Rutegård, Martin, 1982- (författare)
- Umeå University,Umeå universitet,Wallenberg centrum för molekylär medicin vid Umeå universitet (WCMM),Kirurgi,Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden; Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
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(creator_code:org_t)
- John Wiley & Sons, 2024
- 2024
- Engelska.
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Ingår i: Colorectal Disease. - : John Wiley & Sons. - 1462-8910 .- 1463-1318. ; 26:5, s. 974-986
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Aim: Previous research has indicated that preoperative beta blocker therapy is associated with a decreased risk of complications after surgery for rectal cancer. This is thought to arise because of the anti-inflammatory activity of the drug. These results need to be reproduced and analyses extended to other drugs with such properties, as this information might be useful in clinical decision-making. The main aim of this work was to replicate previous findings of beta blocker use as a prognostic marker for postoperative leakage. We also investigated whether drug exposure might induce anastomotic leaks.Method: This is a retrospective multicentre cohort study, comprising 1126 patients who underwent anterior resection for rectal cancer between 2014 and 2018. The use of any preoperative beta blocker was treated as the primary exposure, while anastomotic leakage within 12 months of surgery was the outcome. Secondary exposures comprised angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, statins and metformin. Using multivariable regression, we performed a replication analysis with a predictive aim for beta blockers only, while adjustment for confounding was done in more causally oriented analyses for all drugs. We estimated incidence rate ratio (IRR) and relative risk (RR) with 95% confidence intervals (CIs).Results: Anastomotic leakage occurred in 20.6% of patients. Preoperative beta blockers were used by 22.7% of the cohort, while the leak distribution was almost identical between exposure groups. In the main replication analysis, no association could be detected (IRR 0.95, 95% CI 0.68–1.33). In the causally oriented analyses, only metformin affected the risk of leakage (RR 1.59, 95% Cl 1.31–1.92).Conclusion: While previous research has suggested that preoperative beta blocker use could be prognostic of anastomotic leakage, this study could not detect any such association. On the contrary, our results indicate that preoperative beta blocker use neither predicts nor causes anastomotic leakage after anterior resection for rectal cancer.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
Nyckelord
- adenocarcinoma
- beta blockers
- leak
- metformin
- rectum
- adenocarcinoma
- beta blockers
- leak
- metformin
- rectum
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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