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Erschienen in: Surgery Today 10/2022

23.02.2022 | Original Article

Long-term prognosis of laparoscopic gastrectomy for patients on antithrombotic therapy: a retrospective cohort study

verfasst von: Motohira Yoshida, Hiroyuki Egi, Kei Ishimaru, Shigehiro Koga, Satoshi Akita, Satoshi Kikuchi, Hiroki Sugishita, Jun Kuwabara, Yusuke Ogi, Sayuri Matsui, Yuji Watanabe

Erschienen in: Surgery Today | Ausgabe 10/2022

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Abstract

Purpose

Few studies have reported on the interactions between gastrectomy and antithrombotic therapy, especially the long-term prognosis. We aimed to clarify the short- and long-term prognosis of gastrectomy for patients on antithrombotic therapy.

Methods

We reviewed the perioperative data and survival rate of patients who underwent laparoscopic distal gastrectomy (LDG) at our institute between 2010 and 2013.

Results

There were 119 patients enrolled in this retrospective study: 31 who were taking antithrombotic drugs (antithrombotic therapy (ATT) group), and 88 who were not (non-ATT group). The mean age was significantly higher in the ATT group than in the non-ATT group. No significant differences were observed in the amount of intraoperative bleeding or blood hemoglobin level after surgery between the groups. Bleeding complications occurred in only one patient from the ATT group, and the postoperative complication rate was comparable between the groups. During follow-up, cerebrovascular or cardiovascular events developed in 19.4% of the ATT group patients and 4.5% of the non-ATT group patients; however, there were no significant differences in the 5-year overall survival rates between the groups (ATT group, 76.9%; non-ATT group, 82.9%).

Conclusions

Antithrombotic therapy did not affect the short-term or long-term prognosis of patients after LDG.
Literatur
1.
Zurück zum Zitat Kim W, Kim HH, Han SU, Kim MC, Hyung WJ, Ryu SW, et al. Decreased morbidity of laparoscopic distal gastrectomy compared with open distal gastrectomy for stage I gastric cancer: short-term outcomes from a multicenter randomized controlled trial (KLASS-01). Ann Surg. 2016;263:28–35.CrossRef Kim W, Kim HH, Han SU, Kim MC, Hyung WJ, Ryu SW, et al. Decreased morbidity of laparoscopic distal gastrectomy compared with open distal gastrectomy for stage I gastric cancer: short-term outcomes from a multicenter randomized controlled trial (KLASS-01). Ann Surg. 2016;263:28–35.CrossRef
2.
Zurück zum Zitat Katai H, Mizusawa J, Katayama H, Takagi M, Yoshikawa T, Fukagawa T, et al. Short-term surgical outcomes from a phase III study of laparoscopy-assisted versus open distal gastrectomy with nodal dissection for clinical stage IA/IB gastric cancer: Japan Clinical Oncology Group Study JCOG0912. Gastric Cancer. 2017;20:699–708.CrossRef Katai H, Mizusawa J, Katayama H, Takagi M, Yoshikawa T, Fukagawa T, et al. Short-term surgical outcomes from a phase III study of laparoscopy-assisted versus open distal gastrectomy with nodal dissection for clinical stage IA/IB gastric cancer: Japan Clinical Oncology Group Study JCOG0912. Gastric Cancer. 2017;20:699–708.CrossRef
3.
Zurück zum Zitat Agha R, Abdall-Razak A, Crossley E, Dowlut N, Iosifidis C, Mathew G, et al. STROCSS 2019 guideline: strengthening the reporting of cohort studies in surgery. Int J Surg. 2019;72:156–65.CrossRef Agha R, Abdall-Razak A, Crossley E, Dowlut N, Iosifidis C, Mathew G, et al. STROCSS 2019 guideline: strengthening the reporting of cohort studies in surgery. Int J Surg. 2019;72:156–65.CrossRef
4.
Zurück zum Zitat Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver 3). Gastric Cancer. 2011;14:113–23.CrossRef Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver 3). Gastric Cancer. 2011;14:113–23.CrossRef
5.
Zurück zum Zitat Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14:101–12.CrossRef Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14:101–12.CrossRef
6.
Zurück zum Zitat Thachil J, Gatt A, Martlew V. Management of surgical patients receiving anticoagulation and antiplatelet agents. Br J Surg. 2008;95:1437–48.CrossRef Thachil J, Gatt A, Martlew V. Management of surgical patients receiving anticoagulation and antiplatelet agents. Br J Surg. 2008;95:1437–48.CrossRef
7.
Zurück zum Zitat Hermiz S, Larsen P, Galletly DC, Harding SA. Peri-operative management of anti-platelet agents. ANZ J Surg. 2009;79:521–5.CrossRef Hermiz S, Larsen P, Galletly DC, Harding SA. Peri-operative management of anti-platelet agents. ANZ J Surg. 2009;79:521–5.CrossRef
8.
Zurück zum Zitat Nashimoto A, Akazawa K, Isobe Y, Miyashiro I, Katai H, Kodera Y, et al. Gastric cancer treated in 2002 in Japan: 2009 annual report of the JGCA nationwide registry. Gastric Cancer. 2013;16:1–27.CrossRef Nashimoto A, Akazawa K, Isobe Y, Miyashiro I, Katai H, Kodera Y, et al. Gastric cancer treated in 2002 in Japan: 2009 annual report of the JGCA nationwide registry. Gastric Cancer. 2013;16:1–27.CrossRef
9.
Zurück zum Zitat Mita K, Ito H, Murabayashi R, Sueyoshi K, Asakawa H, Nabetani M, et al. Postoperative bleeding complications after gastric cancer surgery in patients receiving anticoagulation and/or antiplatelet agents. Ann Surg Oncol. 2012;19:3745–52.CrossRef Mita K, Ito H, Murabayashi R, Sueyoshi K, Asakawa H, Nabetani M, et al. Postoperative bleeding complications after gastric cancer surgery in patients receiving anticoagulation and/or antiplatelet agents. Ann Surg Oncol. 2012;19:3745–52.CrossRef
10.
Zurück zum Zitat Artang R, Dieter RS. Analysis of 36 reported cases of late thrombosis in drug-eluting stents placed in coronary arteries. Am J Cardiol. 2007;99:1039–43.CrossRef Artang R, Dieter RS. Analysis of 36 reported cases of late thrombosis in drug-eluting stents placed in coronary arteries. Am J Cardiol. 2007;99:1039–43.CrossRef
11.
Zurück zum Zitat Eisenberg MJ, Richard PR, Libersan D, Filion KB. Safety of short-term discontinuation of antiplatelet therapy in patients with drug-eluting stents. Circulation. 2009;119:1634–42.CrossRef Eisenberg MJ, Richard PR, Libersan D, Filion KB. Safety of short-term discontinuation of antiplatelet therapy in patients with drug-eluting stents. Circulation. 2009;119:1634–42.CrossRef
12.
Zurück zum Zitat Fujikawa T, Tanaka A, Abe T, Yoshimoto Y, Tada S, Maekawa H, et al. Does antiplatelet therapy affect outcomes of patients receiving abdominal laparoscopic surgery? Lessons from more than 1000 laparoscopic operations in a single tertiary referral hospital. J Am Coll Surg. 2013;217:1044–53.CrossRef Fujikawa T, Tanaka A, Abe T, Yoshimoto Y, Tada S, Maekawa H, et al. Does antiplatelet therapy affect outcomes of patients receiving abdominal laparoscopic surgery? Lessons from more than 1000 laparoscopic operations in a single tertiary referral hospital. J Am Coll Surg. 2013;217:1044–53.CrossRef
13.
Zurück zum Zitat Fujikawa T, Ando K. Safety of laparoscopic surgery in digestive diseases with special reference to antithrombotic therapy: a systematic review of the literature. World J Clin Cases. 2018;6:767–75.CrossRef Fujikawa T, Ando K. Safety of laparoscopic surgery in digestive diseases with special reference to antithrombotic therapy: a systematic review of the literature. World J Clin Cases. 2018;6:767–75.CrossRef
14.
Zurück zum Zitat Takahashi K, Ito H, Katsube T, Tsuboi A, Hashimoto M, Ota E, et al. Associations between antithrombotic therapy and the risk of perioperative complications among patients undergoing laparoscopic gastrectomy. Surg Endosc. 2017;31:567–72.CrossRef Takahashi K, Ito H, Katsube T, Tsuboi A, Hashimoto M, Ota E, et al. Associations between antithrombotic therapy and the risk of perioperative complications among patients undergoing laparoscopic gastrectomy. Surg Endosc. 2017;31:567–72.CrossRef
15.
Zurück zum Zitat Ono K, Idani H, Hidaka H, Kusudo K, Koyama Y, Taguchi S. Effect of aspirin continuation on blood loss and postoperative morbidity in patients undergoing laparoscopic cholecystectomy or colorectal cancer resection. Surg Laparosc Endosc Percutan Tech. 2013;23:97–100.CrossRef Ono K, Idani H, Hidaka H, Kusudo K, Koyama Y, Taguchi S. Effect of aspirin continuation on blood loss and postoperative morbidity in patients undergoing laparoscopic cholecystectomy or colorectal cancer resection. Surg Laparosc Endosc Percutan Tech. 2013;23:97–100.CrossRef
16.
Zurück zum Zitat Devereaux PJ, Mrkobrada M, Sessler DI, Leslie K, Alonso-Coello P, Kurz A, et al. Aspirin in patients undergoing noncardiac surgery. N Engl J Med. 2014;370:1494–503.CrossRef Devereaux PJ, Mrkobrada M, Sessler DI, Leslie K, Alonso-Coello P, Kurz A, et al. Aspirin in patients undergoing noncardiac surgery. N Engl J Med. 2014;370:1494–503.CrossRef
17.
Zurück zum Zitat Shimoike N, Fujikawa T, Yoshimoto Y, Tanaka A. Does antiplatelet therapy affect short-term and long-term outcomes of patients undergoing surgery for colorectal cancer? Surgical radicality versus perioperative antiplatelet-related morbidity risks. J Gastroenterol Hepatol Res. 2016;5(2):1962–9.CrossRef Shimoike N, Fujikawa T, Yoshimoto Y, Tanaka A. Does antiplatelet therapy affect short-term and long-term outcomes of patients undergoing surgery for colorectal cancer? Surgical radicality versus perioperative antiplatelet-related morbidity risks. J Gastroenterol Hepatol Res. 2016;5(2):1962–9.CrossRef
18.
Zurück zum Zitat Fujikawa T, Kawamoto H, Kawamura Y, Emoto N, Sakamoto Y, Tanaka A. Impact of laparoscopic liver resection on bleeding complications in patients receiving antithrombotics. World J Gastrointest Endosc. 2017;9:396–404.CrossRef Fujikawa T, Kawamoto H, Kawamura Y, Emoto N, Sakamoto Y, Tanaka A. Impact of laparoscopic liver resection on bleeding complications in patients receiving antithrombotics. World J Gastrointest Endosc. 2017;9:396–404.CrossRef
19.
Zurück zum Zitat Jiang N, Deng JY, Ding XW, Zhang L, Liu HG, Liang YX, et al. Effect of complication grade on survival following curative gastrectomy for carcinoma. World J Gastroenterol. 2014;20:8244–52.CrossRef Jiang N, Deng JY, Ding XW, Zhang L, Liu HG, Liang YX, et al. Effect of complication grade on survival following curative gastrectomy for carcinoma. World J Gastroenterol. 2014;20:8244–52.CrossRef
20.
Zurück zum Zitat Yoshida M, Koga S, Ishimaru K, Yamamoto Y, Matsuno Y, Akita S, et al. Laparoscopy-assisted distal gastrectomy is feasible also for elderly patients aged 80 years and over: effectiveness and long-term prognosis. Surg Endosc. 2017;31:4431–7.CrossRef Yoshida M, Koga S, Ishimaru K, Yamamoto Y, Matsuno Y, Akita S, et al. Laparoscopy-assisted distal gastrectomy is feasible also for elderly patients aged 80 years and over: effectiveness and long-term prognosis. Surg Endosc. 2017;31:4431–7.CrossRef
21.
Zurück zum Zitat Ishikawa H, Mutoh M, Suzuki S, Tokudome S, Saida Y, Abe T, et al. The preventive effects of low-dose enteric-coated aspirin tablets on the development of colorectal tumours in Asian patients: a randomised trial. Gut. 2014;63:1755–9.CrossRef Ishikawa H, Mutoh M, Suzuki S, Tokudome S, Saida Y, Abe T, et al. The preventive effects of low-dose enteric-coated aspirin tablets on the development of colorectal tumours in Asian patients: a randomised trial. Gut. 2014;63:1755–9.CrossRef
22.
Zurück zum Zitat Lapi F, Levi M, Simonetti M, Cancian M, Parretti D, Cricelli I, et al. Risk of prostate cancer in low-dose aspirin users: a retrospective cohort study. Int J Cancer. 2016;139:205–11.CrossRef Lapi F, Levi M, Simonetti M, Cancian M, Parretti D, Cricelli I, et al. Risk of prostate cancer in low-dose aspirin users: a retrospective cohort study. Int J Cancer. 2016;139:205–11.CrossRef
23.
Zurück zum Zitat Kim MH, Chang J, Kim WJ, Banerjee S, Park SM. Cumulative dose threshold for the chemopreventive effect of aspirin against gastric cancer. Am J Gastroenterol. 2018;113:845–54.CrossRef Kim MH, Chang J, Kim WJ, Banerjee S, Park SM. Cumulative dose threshold for the chemopreventive effect of aspirin against gastric cancer. Am J Gastroenterol. 2018;113:845–54.CrossRef
24.
Zurück zum Zitat Rodriguez-Miguel A, Garcia-Rodriguez LA, Gil M, Montoya H, Rodriguez-Martin S, de Abajo FJ. Clopidogrel and low-dose aspirin, alone or together, reduce risk of colorectal cancer. Clin Gastroenterol Hepatol. 2019;17:2024–33 (e2).CrossRef Rodriguez-Miguel A, Garcia-Rodriguez LA, Gil M, Montoya H, Rodriguez-Martin S, de Abajo FJ. Clopidogrel and low-dose aspirin, alone or together, reduce risk of colorectal cancer. Clin Gastroenterol Hepatol. 2019;17:2024–33 (e2).CrossRef
25.
Zurück zum Zitat Sung JJY, Ho JMW, Chan FCH, Tsoi KKF. Low-dose aspirin can reduce colorectal cancer mortality after surgery: a 10-year follow-up of 13,528 colorectal cancer patients. J Gastroenterol Hepatol. 2019;34:1027–34.CrossRef Sung JJY, Ho JMW, Chan FCH, Tsoi KKF. Low-dose aspirin can reduce colorectal cancer mortality after surgery: a 10-year follow-up of 13,528 colorectal cancer patients. J Gastroenterol Hepatol. 2019;34:1027–34.CrossRef
26.
Zurück zum Zitat Douketis JD, Spyropoulos AC, Spencer FA, Mayr M, Jaffer AK, Eckman MH, et al. Perioperative management of antithrombotic therapy: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest. 2012;141:e326S – e350.CrossRef Douketis JD, Spyropoulos AC, Spencer FA, Mayr M, Jaffer AK, Eckman MH, et al. Perioperative management of antithrombotic therapy: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest. 2012;141:e326S – e350.CrossRef
27.
Zurück zum Zitat Baron TH, Kamath PS, McBane RD. Management of antithrombotic therapy in patients undergoing invasive procedures. N Engl J Med. 2013;368:2113–24.CrossRef Baron TH, Kamath PS, McBane RD. Management of antithrombotic therapy in patients undergoing invasive procedures. N Engl J Med. 2013;368:2113–24.CrossRef
28.
Zurück zum Zitat Levine GN, Bates ER, Bittl JA, Brindis RG, Fihn SD, Fleisher LA, et al. 2016 ACC/AHA Guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: a report of the American college of cardiology/American heart association task force on clinical practice guidelines: an update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention, 2011 ACCF/AHA guideline for coronary artery bypass graft surgery, 2012 ACC/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease, 2013 ACCF/AHA guideline for the management of st-elevation myocardial infarction, 2014 AHA/ACC guideline for the management of patients with non-st-elevation acute coronary syndromes, and 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery. Circulation. 2016;134:e123–55.CrossRef Levine GN, Bates ER, Bittl JA, Brindis RG, Fihn SD, Fleisher LA, et al. 2016 ACC/AHA Guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: a report of the American college of cardiology/American heart association task force on clinical practice guidelines: an update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention, 2011 ACCF/AHA guideline for coronary artery bypass graft surgery, 2012 ACC/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease, 2013 ACCF/AHA guideline for the management of st-elevation myocardial infarction, 2014 AHA/ACC guideline for the management of patients with non-st-elevation acute coronary syndromes, and 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery. Circulation. 2016;134:e123–55.CrossRef
Metadaten
Titel
Long-term prognosis of laparoscopic gastrectomy for patients on antithrombotic therapy: a retrospective cohort study
verfasst von
Motohira Yoshida
Hiroyuki Egi
Kei Ishimaru
Shigehiro Koga
Satoshi Akita
Satoshi Kikuchi
Hiroki Sugishita
Jun Kuwabara
Yusuke Ogi
Sayuri Matsui
Yuji Watanabe
Publikationsdatum
23.02.2022
Verlag
Springer Nature Singapore
Erschienen in
Surgery Today / Ausgabe 10/2022
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-022-02479-7

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