J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text HTML] [Full Text PDF] （in Japanese / 527KB） [Members Only]

J.Jpn. Surg. Soc.. 116(5): 334-339, 2015

Special contribution

CURRENT STATUS OF PERIOPERATIVE MANAGEMENT IN PATIENTS UNDERGOING ANTITHROMBOTIC (ANTIPLATELET OR ANTICOAGULATION) THERAPY: RESULTS OF A QUESTIONNAIRE SURVEY

1) Dept of Surgery, Kokura Memorial Hospital, Kitakyushu, Japan
2) Dept of Abdominal Surgery, Tenri Hospital, Tenri, Japan
3) Dept of Gastroenterological Surgery, Kitano Hospital, Osaka, Japan
4) Dept of Surgery, Kyoto Katsura Hospital, Kyoto, Japan
5) Dept of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
6) Dept of Surgery, Otsu Municipal Hospital, Otsu, Japan

Takahisa Fujikawa1), Tsunehiro Yoshimura2), Hiroaki Terajima3), Dai Manaka4), Hiroshi Okabe5)6), Akira Tanaka1)

In non-cardiac surgery patients receiving antithrombotic therapy (antiplatelet therapy (APT) and anticoagulation therapy (ACT)) for prevention of cardiovascular and/or cerebrovascular complications, perioperative antithrombotic management is challenging due to increased risks of both bleeding and thromboembolic complications. The effect of APT and/or ACT on surgical outcomes in patients undergoing general or gastroenterologic surgery is still unknown because of the limited evidence. We conducted a survey of 38 major surgical facilities at Kyoto University Related Hospital Surgical Group of Cancer Research on perioperative management in patients undergoing antithrombotic therapy. In elective surgery, most facilities used heparin substitution during cessation of ACT or APT, while surgery was performed under continuation of APT in 22% of facilities. In emergent surgery, the effect of ACT was reversed before surgery, but surgery was performed without the reversal of APT effect. Laparoscopic surgery was performed in most facilities in spite of the use of ACT or APT. Severe bleeding complications requiring transfusion of fresh frozen plasma or platelet were experienced in over half of facilities. Conclusion: Variation of antithrombotic management has shown to be large between facilities. For safe surgical treatment, creation of the perioperative antithrombotic management guideline on the basis of the evidence from multicenter study is requisite.

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