Continuation of low-dose acetylsalicylic acid during perioperative period of laparoscopic inguinal hernia repair is safe: results of a prospective clinical trial.

PURPOSE

Patients taking acetylsalicylic acid are common in surgical departments; in most cases, acetylsalicylic acid is discontinued 5-7 days before the operation to minimize the intra- and postoperative bleeding, but the perioperative management of patients under antithrombotic and anticoagulative treatments is controversial. This study aims to address whether the low-dose acetylsalicylic acid increases bleeding and occurrence of postoperative complications after laparoscopic inguinal hernia repair when it was only ceased on the operation day.

METHOD

From July 2017 to January 2019, 901 patients including 781 (86.7%) male and 120 (13.3%) female patients underwent laparoscopic inguinal hernia repair using trans-abdominal preperitoneal (TAPP) technique were recruited, among whom 152 (16.9%) had been taking low-dose (100 mg per day) acetylsalicylic acid which was continued during hospitalization except the operation day. The intra-operative bleeding volume, postoperative pain, overall occurrence of complications such as seroma, hematoma, scrotal edema, calf muscle venous thrombosis, and the time of resuming normal activities were compared with patients on whom these medications were not needed.

RESULTS

The age, BMI, hospital stay, ASA classification, morbidity of CHD and hypertension, FIB value, and the time of resuming normal activities of patients taking acetylsalicylic acid were higher (p < 0.05). There was no significant difference on mean operative time, intra-operative bleeding volume, and the occurrence postoperative complications among two groups.

CONCLUSION

For patients with inguinal hernias, laparoscopic TAPP repair is completely safe to be performed on those taking low-dose acetylsalicylic acid when it was only ceased on the operation day, with intravenous salvianolate given after the operation instead.