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Surgery Today

, Volume 44, Issue 12, pp 2243–2248 | Cite as

Feasibility of aspirin continuation during the perioperative period for pulmonary resection in lung cancer patients: a retrospective study at a single institute in Japan

  • Ryu Kanzaki
  • Masayoshi Inoue
  • Masato Minami
  • Yasushi Shintani
  • Tomoyuki Nakagiri
  • Soichiro Funaki
  • Noriyoshi Sawabata
  • Meinoshin Okumura
Original Article

Abstract

Purpose

To evaluate the feasibility of aspirin continuation during the perioperative period for pulmonary resection in lung cancer patients.

Methods

A retrospective study was conducted in 46 patients who were taking aspirin and underwent pulmonary resection. The indications for aspirin were generally a cardiovascular or cerebrovascular comorbidity. Whether to continue or discontinue aspirin was determined based on the severity of the cardiovascular or cerebrovascular comorbidity, along with the patient’s overall condition. The intraoperative and postoperative outcomes were compared between patients continuing and those discontinuing aspirin.

Results

Twenty patients continued (group C) and 26 patients discontinued (group D) aspirin. The length of the operation (226 ± 97 min in group C vs. 189 ± 90 min in group D), intraoperative bleeding (234 ± 232 vs. 204 ± 367 g) and average pleural discharge on postoperative days 1, 2 and 3 (331, 230 and 215 vs. 304, 210 and 174 ml/day) showed no significant differences between the two groups. The postoperative complication rates were also not significantly different between the two groups [eight patients (40 %) in group C vs. nine patients (35 %) in group D].

Conclusions

Continuous administration of aspirin during the perioperative period for pulmonary resection in lung cancer patients appears to be clinically feasible in the Japanese population.

Keywords

Lung cancer Aspirin Surgery 

Notes

Conflict of interest

Ryu Kanzaki and the co-authors have no conflicts of interest to declare.

References

  1. 1.
    Endo H, Yamamoto R, Satoh Y, Kuwano H, Nishizawa N. Risk analysis of pulmonary resection for elderly patients with lung cancer. Surg Today. 2013;43:514–20.CrossRefGoogle Scholar
  2. 2.
    Antithrombotic Trialists’ Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ. 2002;324:71–86.CrossRefGoogle Scholar
  3. 3.
    McFadden EP, Stabile E, Regar E, Cheneau E, Ong AT, Kinnaird T, et al. Late thrombosis in drug-eluting coronary stents after discontinuation of antiplatelet therapy. Lancet. 2004;364:1519–21.PubMedCrossRefGoogle Scholar
  4. 4.
    Sonobe M, Sato T, Chen F, Fujinaga T, Shoji T, Sakai H, et al. Management of patients with coronary stents in elective thoracic surgery. Gen Thorac Cardiovasc Surg. 2011;59:477–82.PubMedCrossRefGoogle Scholar
  5. 5.
    Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Douketis JD, Berger PB, Dunn AS, Jaffer AK, Spyropoulos AC, Becker RC, et al. The perioperative management of antithrombotic therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edition). Chest. 2008;133:299S–339S.PubMedCrossRefGoogle Scholar
  7. 7.
    Fleisher LA, Beckman JA, Brown KA, Calkins H, Chaikof E, Fleischmann KE, et al. ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 2002 guidelines on perioperative cardiovascular evaluation for noncardiac surgery): developed in collaboration with the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery. Circulation. 2007;116:1971–96.PubMedCrossRefGoogle Scholar
  8. 8.
    Poldermans D, Bax JJ, Boersma E, De Hert S, Eeckhout E, Fowkes G, et al. Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery. Eur Heart J. 2009;30:2769–812.PubMedCrossRefGoogle Scholar
  9. 9.
    Saunders E, Ofili E. Epidemiology of atherothrombotic disease and the effectiveness and risks of antiplatelet therapy: race and ethnicity considerations. Cardiol Rev. 2008;16:82–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Kobayashi H. Evaluation of the need to discontinue antiplatelet and anticoagulant medications before cataract surgery. J Cataract Refract Surg. 2010;36:1115–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Shinkai A, Matsumoto Y, Chikuda M. Evaluation of patients undergoing vitreous surgery while on antithrombotic therapy (in Japanese with English abstract). Gannka Rinsho Kiyo (Folia Japonica de Ophthalmologica). 2011;4:433–6.Google Scholar
  12. 12.
    Ohmiya H, Okajima K, Abe Y, Tanoue M, Murakami N, Mori S. Anticoagulant during perioperative stage of spinal surgery (in Japanese with English abstract). Orthop Traumatol. 2007;56:214–6.CrossRefGoogle Scholar
  13. 13.
    Murase A, Yoshida I, Shibata Y, Kawanishi T, Kojima H, Kuroyanagi H. A study of the continuation of aspirin in proximal femoral fracture patients (in Japanese). Central Jpn J Orthop Surg Traumatol. 2011;54:291–2.Google Scholar
  14. 14.
    Tsukahara A, Maruta T, Koyama S, Tanaka N, Takeda N, Shimoda S. Koukesshoubannryouhoushourei ni taisuru shoukakigekashujutu (in Japanese). In: Abstract of the 67th general meeting of the Japanese Society of Gastroenterological Surgery, pp 3–167.Google Scholar
  15. 15.
    Stafford-Smith M. Impaired haemostasis and regional anaesthesia. Can J Anaesth. 1996;43:R129–41.PubMedCrossRefGoogle Scholar
  16. 16.
    Yokoyama M. Antiplatelet drug, anticoagulation therapy, and epidural anesthesia (in Japanese with English abstract). J Jpn Soc Clin Anesth. 2010;30:142–50.CrossRefGoogle Scholar
  17. 17.
    Liu SS, Wu CL. Effect of postoperative analgesia on major postoperative complications: a systematic update of the evidence. Anesth Analg. 2007;104:689–702.PubMedCrossRefGoogle Scholar
  18. 18.
    Beattie WS, Badner NH, Choi PT. Meta-analysis demonstrates statistically significant reduction in postoperative myocardial infarction with the use of thoracic epidural analgesia. Anesth Analg. 2003;97:919–20.PubMedCrossRefGoogle Scholar
  19. 19.
    Kato K, Shinjo Y, Yoshikawa K, Yonei A. A case report of a DES-implanted patient: continuation of antiplatelet therapy would prevent stent thrombosis after surgery (in Japanese with English abstract). J Jpn Soc Clin Anesth. 2011;31:986–9.CrossRefGoogle Scholar
  20. 20.
    Kimura T, Morimoto T, Nakagawa Y, Tamura T, Kadota K, Yasumoto H, et al. Antiplatelet therapy and stent thrombosis after sirolimus-eluting stent implantation. Circulation. 2009;119:987–95.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Japan 2014

Authors and Affiliations

  • Ryu Kanzaki
    • 1
  • Masayoshi Inoue
    • 1
  • Masato Minami
    • 1
  • Yasushi Shintani
    • 1
  • Tomoyuki Nakagiri
    • 1
  • Soichiro Funaki
    • 1
  • Noriyoshi Sawabata
    • 1
  • Meinoshin Okumura
    • 1
  1. 1.Department of General Thoracic SurgeryOsaka University Graduate School of MedicineSuitaJapan

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