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Surgical Endoscopy
Erschienen in: Surgical Endoscopy 12/2016

29.04.2016

Is preoperative withdrawal of aspirin necessary in patients undergoing elective inguinal hernia repair?

verfasst von: Wilson Ong, Tong Shen, Wee Boon Tan, Davide Lomanto

Erschienen in: Surgical Endoscopy | Ausgabe 12/2016

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Abstract

Background

Antiplatelets such as aspirin are widely used to reduce thrombotic events in patients with various cardiovascular comorbidities. Continuing aspirin through noncardiac surgery has been shown to reduce risk of major adverse cardiac events (MACE) but may lead to higher bleeding complications. Inguinal hernia repair is a commonly performed surgical procedure among such patients, but no guideline exists regarding perioperative use of aspirin.

Objective

We aim to investigate the safety profile of aspirin continuation in the perioperative period in patients undergoing elective primary inguinal hernia repair.

Methods

All patients who underwent elective primary inguinal hernia repair from 2008 to 2015 and were on aspirin preoperatively were identified. The patients were divided into two groups: those who continued aspirin through the morning of the operation and those who were advised to stop aspirin therapy 3–7 days prior to operation. All patients underwent either open Lichtenstein mesh repair or laparoscopic total extra-peritoneal mesh repair. Outcomes measured include intraoperative blood loss, operative time, bleeding complications, wound site complications and MACE.

Results

Among 1841 patients who underwent elective primary inguinal hernia mesh repair, 142 (7.7 %) patients were on preoperative aspirin. Fifty-seven patients underwent laparoscopic repair, while 85 underwent open mesh repair. Twenty-seven out of fifty-seven (47.3 %) from the laparoscopic group and 55/85 (64.7 %) from the open group were instructed to stop aspirin (p = 0.040). There were no significant differences between those who stopped aspirin and those who continued in terms of intraoperative blood loss and operative timing. Immediate postoperative bleeding complications and follow-up wound complications were also similar between the two groups. Overall, there were no MACE among those who underwent laparoscopic repair. Three MACE were recorded in the open group (2 stopped vs. 1 continued; p = 0.943). There was no perioperative mortality.

Conclusion

Continuation of aspirin is safe and should be preferred in patients with higher cardiovascular risk.
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Metadaten
Titel
Is preoperative withdrawal of aspirin necessary in patients undergoing elective inguinal hernia repair?
verfasst von
Wilson Ong
Tong Shen
Wee Boon Tan
Davide Lomanto
Publikationsdatum
29.04.2016
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 12/2016
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-016-4926-6

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