***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background Non-steroid anti-inflammatory drugs ( NSAIDs ) have been proposed as part of a multimodal postoperative analgesia in patients operated for colorectal cancer . However , whether these drugs are prescribed and taken by the patients have not been evaluated . The aim of this study was to quantify the postoperative use of NSAIDs in these patients . Methods Data from patients operated for colorectal cancer between January 1 , 2006 and December 31 , 2009 were collected from the Danish Colorectal Cancer Group ’s ( DCCG ) prospect i ve data base . From the electronically registered medical records , data for the use of the two NSAIDs diclofenac and ibuprofen were recorded . The data from six colorectal departments in eastern Denmark were compared . Results Of the 2,754 patients analyzed overall , 40.6 % received NSAIDs as part of their analgesic treatment . The percentage of the patients receiving NSAIDs  , receiving a pre-defined dosage as a minimum and receiving NSAIDs as p.r.n . medication , and the type of NSAID were significantly different both between department and within departments . The median dose of ibuprofen and diclofenac were 1200 mg ( 400–2,400 mg ) and 100 mg ( 50–200 mg ) , respectively . Conclusions The large variation between and within the departments points to an inconsistency in the use of multimodal post-operative pain treatments . This may be a result of insufficient evidence on procedure specific pain treatments and possibly a lack of compliance to existing guidelines . High- quality large-scale studies are warranted to form the basis for guidelines for postoperative analgesic treatment Cancer cells treated with the cyclooxygenase-2 inhibitor celecoxib show growth inhibition and induced apoptosis . This study was conducted to determine if the same processes are relevant to celecoxib 's effects on human colorectal adenocarcinomas treated in vivo . A cohort of 23 patients with primary colorectal adenocarcinomas was r and omised to receive a 7-d course of celecoxib ( 400 mg b.i.d . ) or no drug prior to surgical resection .  Gene expression profiling was performed on resected adenocarcinomas from the cohort of patients . Using fold change ( > 1.5 ) and p-value ( < 0.05 ) cut-offs , 190 genes were differentially expressed between adenocarcinomas from patients receiving celecoxib and those that did not . The celecoxib pre-treated sample s showed decreased expression levels in multiple genes involved in cellular lipid and glutathione metabolism ; changes associated with diminished cellular proliferation .  Celecoxib pre-treatment for 7 d in vivo is associated with alterations in colorectal adenocarcinoma gene expression which are suggestive of diminished cellular proliferation OBJECTIVE To evaluate the impact of preemptive local analgesia at the incision site in reducing pain in women undergoing abdominal hysterectomy for a benign myomatous uterus . STUDY DESIGN In this prospect i ve , r and omized , double-blinded , placebo-controlled study , 20 mL of 1 % lidocaine or 0.9 % saline was injected at the abdominal incision site prior to the performance of the hysterectomy . Thirty-two women were enrolled in the study , 16 received preemptive analgesia while 14 were treated by placebo ; 2 were excluded . All operations were performed under general anesthesia . The st and ard postoperative pain treatment consisted of oral analgesia with ibuprofen ( 400 mg ) in liquid-filled capsules . Morphine ( 10 mg ) was used for rescue analgesia . Pain intensity was self-evaluated with the use of a 100 mm visual analog scale . RESULTS Compared to the placebo group , women who received preemptive analgesia with lidocaine 1 % perceived a significant reduction in postoperative pain in the first hours after surgery ( 2 h : 50.1+/-27.9 versus 70.6+/-22.6 , p=0.043 ; 5 h : 42.5+/-25.2 versus 64.6+/-28.3 , p=0.043 ; 8 h : 31.2+/-22.4 versus 53.3+/-30.3 , p=0.031 ) . CONCLUSION Preemptive analgesia with lidocaine 1 % is a simple , cheap and efficient mode to reduce pain in the first hours after hysterectomy Purpose During cancer surgery , prostagl and in-mediated inflammation may promote and activate micrometastatic disease with a consequent increase in long-term cancer recurrence . Cyclooxygenase-2 inhibitors , known to have anti-proliferative properties , may offset such perioperative perturbation . We investigated the effectiveness of these agents to minimize inflammatory changes during cancer surgery . Methods Following ethics approval , 32 patients who were to undergo major intracavity cancer surgery were enrolled in this prospect i ve , r and omized , clinical trial . The treatment group received 400 mg celecoxib preoperatively followed by five 200 mg 12-hourly doses . The control group received no anti-inflammatory agents .  Inflammatory and immunomodulatory end points were measured serially . The primary end points were the measured plasma and urinary prostagl and in E metabolite ( PGEM ) levels 48 hours following surgery . Secondary endpoints included interleukin levels , leucocyte profile , and clinical end points . Results No differences in the 48-hr plasma or urinary PGEM levels were observed between the celecoxib and control groups . Linear mixed modeling , used to accommo date differences in baseline PGEM levels , showed that celecoxib ( cf . control ) administration lowered plasma PGEM over the entire 48-hr period following surgery ( β-coefficient = −0.38 pg.ml−1 ; 95 % confidence interval : −0.69 to −0.06 ; P = 0.021 ) . Celecoxib administration also lowered postoperative pain scores . Discussion St and ard dosing of the cyclooxygenase-2 inhibitor celecoxib slightly reduced perioperative cyclooxygenase activity during cancer surgery . Given cyclooxygenase ’s role in cancer pathways , we recommend dose-finding studies be undertaken before prospect i ve clinical trials are conducted testing the currently unsubstantiated hypothesis that perioperative anti-inflammatory administration improves long-term cancer outcomes . This trial was registered at : Australian New Zeal and Clinical Trial Registry : ACTRN12615000041550 ; www.anzctr.org.auRésuméObjectifPendant les chirurgies du cancer , l’inflammation médiée par les prostagl and ines pourrait favoriser et activer une maladie micrométastatique avec une augmentation conséquente de la récurrence du cancer à long terme . Les inhibiteurs de la cyclo-oxygénase-2 , do nt on connaît les propriétés antiprolifératives , pourraient compenser une telle perturbation périopératoire . Nous avons étudié l’efficacité de ces agents pour minimiser les changements inflammatoires pendant les chirurgies du cancer . MéthodeAprès avoir obtenu le consentement du Comité d’éthique , 32 patients devant subir une chirurgie ouverte majeure pour un cancer ont été enrôlés dans cette étude clinique prospect i ve et r and omisée . Le groupe traitement a reçu 400 mg de célécoxib avant l’opération , puis cinq doses de 200 mg aux 12 heures . Le groupe témoin n’a reçu aucun agent anti-inflammatoire . Les critères d’évaluation d’inflammation et d’immunomodulation ont été mesurés en série . Les critères d’évaluation principaux étaient les taux de métabolites des prostagl and ines E ( PGEM ) mesurés dans le plasma et dans l’urine 48 h après la chirurgie . Les critères d’évaluation secondaires comprenaient les taux d’interleukine , le profil leucocytaire ainsi que des critères d’évaluation cliniques . RésultatsAucune différence n’a été observée dans les taux de PGEM dans le plasma ou l’urine à 48 h entre le groupe célécoxib et le groupe témoin . Un modèle linéaire mixte , utilisé pour tenir compte des différences dans les taux de base de PGEM , a démontré que l’administration de célécoxib réduisait les PGEM dans le plasma tout au long de la période de 48 h suivant la chirurgie ( coefficient β = −0,38 ; intervalle de confiance 95 % : −0,69 à −0,06 ; P = 0,021 ) . L’administration de célécoxib a également réduit les scores de douleur postopératoires . Discussion Une posologie st and ard de l’inhibiteur de cyclo-oxygénase 2 qu’est le célécoxib a légèrement réduit l’activité périopératoire de la cyclo-oxygénase pendant une chirurgie du cancer . Étant donné le rôle de la cyclo-oxygénase dans les voies de développement du cancer , nous recomm and ons de tester l’hypothèse , actuellement non vérifiée , selon laquelle l’administration périopératoire d’anti-inflammatoires améliorerait les pronostics oncologiques à long terme , avant de réaliser des études cliniques prospect ives . Cette étude est enregistrée au : Registre australien et néozél and ais des études cliniques : ACTRN12615000041550 ; OBJECTIVE To determine pre-/intraoperative risk factors for anastomotic leak after colon resection for cancer and to create a practical instrument for predicting anastomotic leak risk . BACKGROUND Anastomotic leak is still the most dreaded complication in colorectal surgery . Many risk factors have been identified to date , but multicentric prospect i ve studies on anastomotic leak after colon resection are lacking . METHODS Fifty-two hospitals participated in this prospect i ve , observational study . Data of 3193 patients , operated for colon cancer with primary anastomosis without stoma , were included in a prospect i ve online data base ( September 2011-September 2012 ) . Forty-two pre-/intraoperative variables , related to patient , tumor , surgical procedure , and hospital , were analyzed as potential independent risk factors for anastomotic leak ( 60-day follow-up ) . A nomogram was created to easily predict the risk of anastomotic leak for a given patient . RESULTS The anastomotic leak rate was 8.7 % , and widely varied between hospitals ( variance of 0.24 on the logit scale ) . Anastomotic leak significantly increased mortality ( 15.2 % vs 1.9 % in patients without anastomotic leak , P < 0.0001 ) and length of hospitalization ( median 23 vs 7 days in uncomplicated patients , P < 0.0001 ) . In the multivariate analysis , the following variables were independent risk factors for anastomotic leak : obesity [ P = 0.003 , odds ratio ( OR ) = 2.7 ] , preoperative serum total proteins ( P = 0.03 , OR = 0.7 per g/dL ) , male sex ( P = 0.03 , OR = 1.6 ) , ongoing anticoagulant treatment ( P = 0.05 , OR = 1.8 ) , intraoperative complication ( P = 0.03 , OR = 2.2 ) , and number of hospital beds ( P = 0.04 , OR = 0.95 per 100 beds ) . CONCLUSIONS Anastomotic leak after colon resection for cancer is a frequent , relevant complication . Patients , surgical technique , and hospital are all important determining factors of anastomotic leak risk BACKGROUND : Nonsteroidal anti-inflammatory drugs have become an important component of narcotic-sparing postoperative pain management protocol s. However , conflicting evidence exists regarding the adverse association of nonsteroidal anti-inflammatory drug use with intestinal anastomotic healing in colorectal surgery . OBJECTIVE : This study compares patients receiving nonsteroidal anti-inflammatory drugs on postoperative day 1 with patients who did not receive nonsteroidal anti-inflammatory drugs  with regard to the occurrence of anastomotic leaks . DESIGN : This is a retrospective study from a protocol -driven prospect ively collected statewide data base . A propensity score model was used to adjust for differences between the groups in patient demographics , characteristics , comorbidities , and laboratory values . SETTING S : The multicenter data set used in this analysis represents a variety of academic and community hospitals within the state of Michigan from July 2012 through February 2014 . PATIENTS : Nonpregnant patients over the age of 18 who underwent colon and rectal surgery with bowel anastomosis were selected . MAIN OUTCOME MEASURES : Occurrence of anastomotic leak , composite surgical site infection , sepsis , and death within 30 days of surgery were the primary outcomes measured . RESULTS : A total of 4360 patients met inclusion criteria , of which 1297 ( 29.7 % ) received nonsteroidal anti-inflammatory drugs and 3063 ( 7 
    Output:
    
Conclusions The literature is not conclusive on whether the use of NSAIDs is associated with anastomotic leaks after gastrointestinal cancer surgery .
Also , the current evidence is equivocal regarding the effects of short-term NSAIDs on cancer recurrence after major cancer surgery .
There are no registered RCTs that are testing the hypothesis of whether the perioperative use of NSAIDs increases the rate of anastomotic leaks