Perioperative medicine & outcomes
Single-dose Preoperative Glucocorticoids in Major Gastrointestinal Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Authors' conclusion
Single-dose preoperative systemic glucocorticoids reduce postoperative morbidity, infections, and length of stay after major gastrointestinal surgery, without evidence of increased surgical harm in included trial populations.
Study context
- Population
- Adults undergoing major gastrointestinal surgery
- Participants
- 3,667 adults · 18 RCTs
- Comparison
- Single preoperative systemic glucocorticoid vs placebo or no steroid
- Outcome
- Total postoperative complications and infectious complications
Methodological detailsPRISMA-compliant, random-effects models, prespecified exploratory dose-stratified analyses
- PRISMA-compliant
- Random-effects models
- Prespecified exploratory dose-stratified analyses
Pooled result
As reported in the abstract
Glucocorticoids vs Placebo or no steroidOdds ratio (95% CI)
Total postoperative complications; I²=12%
0.69(0.54–0.89)
Infectious complications; I²=55%
0.62(0.45–0.88)
Further pooled results
LOS
- LOS reduced by 1.09 days with preoperative glucocorticoids
- 1.09 days (95% CI: −1.68 to −0.50)
POD 1 inflammatory markers
- IL-6 lower with glucocorticoids
- CRP showed no consistent difference
Anastomotic leak and mortality
- Not increased
Dose-stratified analyses
- Greater benefit suggested with higher-dose regimens
- Exploratory
Original publication
Single-dose Preoperative Glucocorticoids in Major Gastrointestinal Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Ann Surg. Published 4 September 2026. doi:10.
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