Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Gastric Cancer. 2023 Sep;26(5):833-842. doi: 10.1007/s10120-023-01410-4. Epub 2023 Jun 17.
As there is no consensus on the impact of antithrombotic drugs on post-gastrectomy outcomes in gastric cancer patients, this study aimed to investigate the impact of antithrombotic drugs on postoperative outcomes in these patients after gastrectomy.
Patients with Stage I-III primary gastric cancer who underwent radical gastrectomy between April 2005 and May 2022 were included. We performed propensity score matching to adjust for patient background and compared bleeding complications. Multivariate analysis with logistic regression analysis was performed to identify risk factors associated with bleeding complications.
Of the 6798 patients, 310 (4.6%) were in the antithrombotic group and 6488 (95.4%) were in the non-antithrombotic group. Twenty-six patients (0.38%) experienced bleeding complications. After matching, the number of patients in each group was 300, with insignificant differences in any factor. A comparison of postoperative outcomes showed no difference in bleeding complications (P = 0.249). In the antithrombotic group, 39 (12.6%) continued drugs, and 271 (87.4%) discontinued them before surgery. After matching, there were 30 and 60 patients, respectively, with no differences in patient background. A comparison of postoperative outcomes showed no differences in bleeding complications (P = 0.551). In multivariate analysis, antithrombotic drug use and continuation of antiplatelet agents were not risk factors for bleeding complications.
Antithrombotic drugs and its continuation may not worsen bleeding complications in patients with gastric cancer after radical gastrectomy. Bleeding complications were rare, and further studies are needed on risk factors for bleeding complications in larger databases.
由于抗血栓药物对胃癌患者胃切除术后结局的影响尚无共识，本研究旨在探讨抗血栓药物对接受根治性胃切除术的胃癌患者术后结局的影响。
纳入 2005 年 4 月至 2022 年 5 月期间接受根治性胃切除术的 I-III 期原发性胃癌患者。我们进行倾向评分匹配以调整患者背景，并比较出血并发症。采用多变量逻辑回归分析进行分析，以确定与出血并发症相关的风险因素。
在 6798 例患者中，310 例（4.6%）为抗血栓药物组，6488 例（95.4%）为非抗血栓药物组。26 例（0.38%）发生出血并发症。匹配后，每组患者人数为 300 例，任何因素均无显著差异。对术后结局进行比较，出血并发症无差异（P=0.249）。在抗血栓药物组中，39 例（12.6%）继续使用药物，271 例（87.4%）在术前停用。匹配后，分别有 30 例和 60 例患者，患者背景无差异。对术后结局进行比较，出血并发症无差异（P=0.551）。多变量分析显示，抗血栓药物使用和抗血小板药物的继续使用不是出血并发症的风险因素。
抗血栓药物及其继续使用可能不会使接受根治性胃切除术的胃癌患者的出血并发症恶化。出血并发症罕见，需要在更大的数据库中进一步研究出血并发症的风险因素。
