BACKGROUND: Anti-thrombotic medications are commonly used for the treatment and prevention of cardiovascular diseases. Laparoscopic resection of colon cancer has generally been accepted with favorable outcomes being reported in randomized control trials. However, the safety and efficacy of laparoscopic surgery for colon cancer patients receiving chronic anti-thrombotic therapy (AT) remain unclear. METHODS: We identified 951 patients who underwent elective resection for colon cancer between 2009 and 2016 from our database. Patients were classified according to the surgical approach and chronic AT. Clinicopathological factors and surgical outcomes were analyzed between patient groups. Patients' backgrounds were matched using propensity scores in laparoscopic surgery. RESULTS: Anti-thrombotic drugs were chronically used in 135 patients. Among 714 patients who underwent laparoscopy-assisted surgery, 96 received AT. The laparoscopic approach was superior to open surgery in terms of bleeding, surgical site infections, and hospital stay in patients receiving AT. In laparoscopy-assisted surgery, the AT group patients were older and showed lower hemoglobin and albumin levels than those not receiving AT (non-AT group), and were predominantly male. After propensity score matching, estimated blood loss and operative times were similar between the two groups (93 matched patients). The frequencies of postoperative bleeding (2.2%) and thrombotic complications (0%) in the AT group did not significantly differ from those in the non-AT group (1.1 and 0%, respectively). Moreover, AT did not affect survivals. CONCLUSION: Laparoscopic approach appears to be safer and beneficial for colonic cancer patients receiving long-term AT. Bleeding and thrombotic events associated with laparoscopic surgery were not significantly affected by AT.
BACKGROUND: Anti-thrombotic medications are commonly used for the treatment and prevention of cardiovascular diseases. Laparoscopic resection of colon cancer has generally been accepted with favorable outcomes being reported in randomized control trials. However, the safety and efficacy of laparoscopic surgery for colon cancerpatients receiving chronic anti-thrombotic therapy (AT) remain unclear. METHODS: We identified 951 patients who underwent elective resection for colon cancer between 2009 and 2016 from our database. Patients were classified according to the surgical approach and chronic AT. Clinicopathological factors and surgical outcomes were analyzed between patient groups. Patients' backgrounds were matched using propensity scores in laparoscopic surgery. RESULTS: Anti-thrombotic drugs were chronically used in 135 patients. Among 714 patients who underwent laparoscopy-assisted surgery, 96 received AT. The laparoscopic approach was superior to open surgery in terms of bleeding, surgical site infections, and hospital stay in patients receiving AT. In laparoscopy-assisted surgery, the AT group patients were older and showed lower hemoglobin and albumin levels than those not receiving AT (non-AT group), and were predominantly male. After propensity score matching, estimated blood loss and operative times were similar between the two groups (93 matched patients). The frequencies of postoperative bleeding (2.2%) and thrombotic complications (0%) in the AT group did not significantly differ from those in the non-AT group (1.1 and 0%, respectively). Moreover, AT did not affect survivals. CONCLUSION: Laparoscopic approach appears to be safer and beneficial for colonic cancerpatients receiving long-term AT. Bleeding and thrombotic events associated with laparoscopic surgery were not significantly affected by AT.
Authors: Ruben Veldkamp; Esther Kuhry; Wim C J Hop; J Jeekel; G Kazemier; H Jaap Bonjer; Eva Haglind; Lars Påhlman; Miguel A Cuesta; Simon Msika; Mario Morino; Antonio M Lacy Journal: Lancet Oncol Date: 2005-07 Impact factor: 41.316
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Authors: Ioannis M Varkarakis; Soroush Rais-Bahrami; Mohamad E Allaf; Guilherme C Lima; Sompol Permpongkosol; Pravin Rao; Thomas W Jarrett; Louis R Kavoussi Journal: J Urol Date: 2005-09 Impact factor: 7.450
Authors: Pierre J Guillou; Philip Quirke; Helen Thorpe; Joanne Walker; David G Jayne; Adrian M H Smith; Richard M Heath; Julia M Brown Journal: Lancet Date: 2005 May 14-20 Impact factor: 79.321
Authors: Heidi Nelson; Daniel J Sargent; H Sam Wieand; James Fleshman; Mehran Anvari; Steven J Stryker; Robert W Beart; Michael Hellinger; Richard Flanagan; Walter Peters; David Ota Journal: N Engl J Med Date: 2004-05-13 Impact factor: 91.245