The impact of preoperative corticosteroids on the systemic inflammatory response and postoperative complications following surgery for gastrointestinal cancer: a systematic review and meta-analysis

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McSorley, Stephen T. ; Horgan, Paul G. ; McMillan, Donald C. (2016)

Background:\ud \ud This meta-analysis examined the impact of preoperative corticosteroids on interleukin 6 (IL-6), C-reactive protein (CRP), and complications following surgery for gastrointestinal cancer.\ud \ud Methods:\ud \ud A systematic review was performed using appropriate keywords. Random-effects meta-analysis was performed.\ud \ud Results:\ud \ud 11 RCTs with 474 patients, were included. Corticosteroids were significantly associated with lower IL-6 on postoperative day 1 (mean difference −148 pg/mL, 95% CI −205 to −92, p < 0.001), 2 (–33 pg/mL, 95% CI −58 to −8, p = 0.01), and 3 (–31 pg/mL, 95% CI −52 to −11, p = 0.002), lower CRP on day 3 (–45 mg/L, 95% CI −68 to −21, p<0.001), and 7 (–14 mg/L, 95% CI −27 to −1, p = 0.04), and fewer postoperative infective complications (OR 0.47, 95% CI 0.26 to 0.83, p = 0.01).\ud \ud Conclusion:\ud \ud Corticosteroids were associated with reduction in the postoperative systemic inflammatory response and complications following surgery for gastrointestinal cancer.
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