Early postoperative non-steroidal anti-inflammatory drugs and anastomotic leakage after oesophagectomy.

This article investigates the association between early postoperative use of non-steroidal anti-inflammatory drugs (NSAIDs) and anastomotic leakage following oesophagectomy for cancer, using a retrospective analysis of a Japanese nationwide inpatient database. Among 39,418 patients studied, 41% received NSAIDs within the day of and the day after surgery, and anastomotic leakage occurred in 15% of cases. Adjusted analyses—including stabilized inverse probability of treatment weighting, propensity score matching, multivariable regression, and instrumental variable analysis—found no significant increase in anastomotic leakage or other complications such as acute kidney injury, gastrointestinal bleeding, or mortality associated with early NSAID use. Subgroup analyses showed a slight statistical association between NSAID use and leakage only in patients younger than 70 years, though this was considered likely due to chance. The study concludes that early postoperative NSAID administration can be safely incorporated into multimodal analgesia protocols after oesophagectomy without increasing major postoperative complications.