Department of General Surgery, Istanbul University Istanbul Faculty of Medicine, Istanbul-Turkey.
Ulus Travma Acil Cerrahi Derg. 2022 Jun;28(6):776-780. doi: 10.14744/tjtes.2022.92442.
The use of antitrombotic (antiaggregant and anticoagulant) drugs is increasing all over the world and in our coun-try. About 12.6% of patients who underwent gastrointestinal tumor surgery receive antitrombotic therapy for various reasons, and in this study, we aimed to demonstrate the safe feasibility of elective or emergency gastrointestinal tumor surgery with the correct perioperative antitrombotic therapy management.
The patients who were planned for gastrointestinal tumor surgery under antitrombotic treatment were analyzed in three groups as those whose pre-operative treatment management treatment was discontinued, those who underwent bridging treat-ment, and those whose treatment continued. Anti-embolic stockings or intermittent pneumatic compression devices were applied to all patients preoperatively and postoperatively as mechanical prophylaxis. Post-operative complications, especially post-operative bleeding and thrombosis, were evaluated using the Clavien-Dindo post-operative complication classification.
When patients who were under antithrombotic therapy, whose therapy was discontinued, and who underwent surgery under bridging therapy, no significant difference was found between the three groups in terms of bleeding complications.
In tertiary centers with high clinical experience, elective and emergency gastrointestinal system tumour surgery can be safely performed under antitrombotic therapy without increasing the thromboembolic risk.
抗血栓（抗聚集和抗凝）药物的使用在全球和我国都在增加。大约 12.6%接受胃肠肿瘤手术的患者因各种原因接受抗血栓治疗，在本研究中，我们旨在证明正确的围手术期抗血栓治疗管理下，择期或紧急胃肠肿瘤手术的安全可行性。
对接受抗血栓治疗的胃肠肿瘤手术患者进行分组分析，分别为术前治疗管理停止、桥接治疗和继续治疗。所有患者术前和术后均应用抗栓袜或间歇性气动压缩装置进行机械预防。术后并发症，特别是术后出血和血栓形成，采用 Clavien-Dindo 术后并发症分类进行评估。
在接受抗血栓治疗、停止治疗和桥接治疗下接受手术的患者中，三组之间出血并发症无显著差异。
在具有高临床经验的三级中心，在不增加血栓栓塞风险的情况下，可安全地进行择期和紧急胃肠道系统肿瘤手术。
