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Impact of antithrombotic agents on short-term outcomes following minimally invasive colorectal cancer surgery: a propensity score-matched analysis

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Abstract

Background

It remains unclear whether minimally invasive colorectal cancer (CRC) surgery under the suitable management of perioperative antithrombotic therapy (ATT) is safe and feasible in patients treated with chronic ATT. The present study aimed to assess the impact of ATT on short-term outcomes following minimally invasive CRC surgery.

Methods

We retrospectively analyzed 1495 consecutive patients who underwent elective minimally invasive CRC surgery between 2011 and 2021, using propensity score-matched analysis.

Results

Overall, 230 patients had chronically received ATT. After propensity score matching, we enrolled 412 patients (n = 206 in each group). Before matching, significant group-dependent differences were observed in terms of sex (p < 0.01), age (p < 0.01), American Society of Anesthesiologists’ physical status (p < 0.01), body mass index (p < 0.01), and pathological N classification (p = 0.03). The frequencies of overall postoperative complications, bleeding events, and thromboembolic events were significantly higher in the ATT group than in the Non-ATT group (p < 0.01). After matching, no significant differences were found between the groups in terms of clinical or surgical characteristics, or in terms of the frequency of overall postoperative complications, bleeding events, thromboembolic events, length of postoperative stay, or any other postoperative complication. Multivariate analysis identified no significant risk factors for postoperative bleeding events or severe postoperative complications associated with ATT.

Conclusions

Patients treated with chronic ATT showed acceptable short-term outcomes for minimally invasive CRC surgery compared with those not receiving ATT. Minimally invasive CRC surgery appears safe and feasible under the suitable management of perioperative ATT regardless of whether the patient has a history of ATT.

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Authors and Affiliations

  1. Department of Surgery, Osaka Rosai Hospital, Sakai, Japan

    Toshinori Sueda, Mitsuyoshi Tei, Kentaro Nishida, Masatoshi Nomura, Yukihiro Yoshikawa, Tae Matsumura, Chikato Koga, Hiromichi Miyagaki, Masanori Tsujie & Yusuke Akamaru

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  1. Toshinori Sueda
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  2. Mitsuyoshi Tei
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  3. Kentaro Nishida
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Contributions

TS contributed to the conception and design, acquisition of data, analysis and interpretation of data, drafting of the article, and has made final approval of the manuscript. MT contributed to the conception and design and has made final approval of the manuscript. KN, MN, YY, CK, HM, MT, and YA contributed to the revision of the manuscript critically for important intellectual content and have made final approval of the manuscript.

Corresponding author

Correspondence to Toshinori Sueda.

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Ethics approval

The Institutional Review Board of Osaka Rosai Hospital approved by the study (approval number 2021–14). This study was eligible for exemption of informed consent. No animal experiments were performed in this study.

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The authors declare no conflict of interest.

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Sueda, T., Tei, M., Nishida, K. et al. Impact of antithrombotic agents on short-term outcomes following minimally invasive colorectal cancer surgery: a propensity score-matched analysis. Int J Colorectal Dis 37, 1049–1062 (2022). https://doi.org/10.1007/s00384-022-04148-0

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