Giving glukortikoid before abdominal surgery reduced major complications and helping patients to get out of the hospital faster. Because glucocorticoid administration beneficial in reducing post-surgical inflammatory response. This is the findings of the meta-analysis. In a meta-analysis, data were collected from 11 randomized clinical trials with a total of 439 patients.
Prophylactic glucocorticoids significantly reduced the incidence of complications (odds ratio [OR] 0.37, p <0.01), with minimal heterogeneity. Prophylactic glucocorticoids also reduce infectious complications (OR = 0.35, p <0.01) with minimal heterogeneity. Long hospitalization with administration of glucocorticoids is
shorter, an average of 2 days (p = 0.01), but with high heterogeneity. Glucocorticoid treatment also lowers levels of interleukin-6 (pro-inflammatory mediators) serum on the first day after surgery, with an average value of 55 pg / mL (p <0.01), also with high heterogeneity.
In additional analysis, administration of glucocorticoids prior to liver resection significantly reduced the incidence of complications (OR = 0.28) and lower average hospitalization time of less than 2 days. Prophylactic also tend to reduce the complications of colon and rectum (OR = 0.45) and lowered the average time of hospitalization of approximately 1 day. Glucocorticoids did not appear to increase the risk of anastomotic leakage on the operation of the colon and rectum. However, because the number of patients small, the effect of glucocorticoids on the leakage of the anastomosis can not be stated definitively. This study has several weaknesses, such as the relatively small number of patients and use of various kinds of glucocorticoids with different doses. Use of glucocorticoids can also cause some adverse effects, such as hyperglycemia, delayed wound healing, and susceptibility to infection.
In conclusion, this meta-analysis showed a positive benefit. Thus, administration of glucocorticoids prior to surgery should be performed routinely in patients who fit, while waiting to do long-term clinical trials. Before giving glucocorticoids, also need to consider the potential benefits and risks of side effects that will arise.
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