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Postoperative Bleeding Complications after Gastric Cancer Surgery in Patients Receiving Anticoagulation and/or Antiplatelet Agents

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Perioperative antithrombotic treatment for gastric cancer patients receiving chronic anticoagulation and/or antiplatelet agents requires an understanding of potential bleeding and thromboembolic risks. However, no study has examined the safety aspects of perioperative antithrombotic treatment during radical gastrectomy. This study sought to evaluate postoperative bleeding and thromboembolic complications after radical gastrectomy in patients undergoing perioperative antithrombotic treatment.

Methods

The medical records of patient treated by radical gastrectomy from January 2006 to December 2010 were retrospectively reviewed. Those in the thromboprophylaxis group had received one of three regimens of perioperative antithrombotic treatment according to the clinical indications of chronic anticoagulation and/or antiplatelet agents and several published evidence-based recommendations: (1) bridging therapy with unfractionated heparin; (2) continuation of aspirin; or (3) both 1 and 2. multivariate analysis was used to identify risk factors for postoperative bleeding complications after radical gastrectomy.

Results

During the study period, 340 patients underwent radical gastrectomy. Of these, 62 patients received perioperative antithrombotic treatment; this thromboprophylaxis group had a significantly higher postoperative bleeding rate (8.1 vs. 0.7 %, P = 0.003). However, other complications, including thromboembolic events, were similar in the two study groups. Multivariate analysis revealed that perioperative antithrombotic treatment was the only independent risk factor of postoperative bleeding complications after radical gastrectomy (odds ratio, 8.53; 95 % confidence interval, 1.47–49.39; P = 0.017).

Conclusions

Perioperative antithrombotic treatment is an independent risk factor of postoperative bleeding complications in patients with gastric cancer undergoing radical gastrectomy, although such treatment was effective in preventing postoperative thromboembolic events.

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Authors and Affiliations

  1. Department of Surgery, New-Tokyo Hospital, Matudo, Chiba, Japan

    Kazuhito Mita MD, Hideto Ito MD, PhD, Ryo Murabayashi MD, Kouichirou Sueyoshi MD, Hideki Asakawa MD, Masashi Nabetani MD, Akira Kamasako MD, Kazuya Koizumi MD & Takashi Hayashi MD, PhD

Authors
  1. Kazuhito Mita MD
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  2. Hideto Ito MD, PhD
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  3. Ryo Murabayashi MD
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  4. Kouichirou Sueyoshi MD
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  5. Hideki Asakawa MD
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  6. Masashi Nabetani MD
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  7. Akira Kamasako MD
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  8. Kazuya Koizumi MD
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  9. Takashi Hayashi MD, PhD
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Correspondence to Kazuhito Mita MD.

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Mita, K., Ito, H., Murabayashi, R. et al. Postoperative Bleeding Complications after Gastric Cancer Surgery in Patients Receiving Anticoagulation and/or Antiplatelet Agents. Ann Surg Oncol 19, 3745–3752 (2012). https://doi.org/10.1245/s10434-012-2500-6

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  • DOI: https://doi.org/10.1245/s10434-012-2500-6

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