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Postoperative Bleeding After Esophagectomy for Esophageal Cancer in Patients Receiving Antiplatelet and Anticoagulation Treatment.

接受抗血小板和抗凝治疗的食管癌患者食管癌切除术后出血。

  • 影响因子:1.90
  • DOI:10.21873/anticanres.14204
  • 作者列表:"Aoyama T","Atsumi Y","Hara K","Kazama K","Tamagawa H","Tamagawa A","Komori K","Maezawa Y","Kano K","Hashimoto I","Oshima T","Murakawa M","Numata M","Yukawa N","Masuda M","Rino Y
  • 发表时间:2020-04-01
Abstract

BACKGROUND:The aim of the present study was to evaluate the clinical impact of the perioperative use of antiplatelet/anticoagulation therapy for postoperative bleeding after esophagectomy for esophageal cancer. PATIENTS AND METHODS:Patients were selected from the medical records of consecutive patients who were diagnosed with primary esophageal adenocarcinoma or squamous cell carcinoma and who underwent complete resection at Yokohama City University from January 2005 to September 2018. The patients were divided into the antiplatelet/anticoagulation treatment group and the non-treatment group. We compared the safety and feasibility of esophagectomy between two groups. RESULTS:One hundred and twenty-two patients underwent esophagectomy for esophageal cancer and were analyzed in the present study. Among them, 18 (14.8%) received anti-thrombotic therapy (anticoagulation group). The incidence of postoperative bleeding in patients overall was 8.2% (10/122). The incidence of postoperative bleeding in the anticoagulation group was 22.2% (4/18), while that in the non-anticoagulation group was 5.8% (6/104). Preoperative anticoagulation therapy was identified as a significant independent risk factor for postoperative bleeding (hazard ratio=4.673, 95% confidence interval=1.170-18.519; p=0.029). CONCLUSION:The perioperative use of anti-thrombotic therapy was a significant risk factor for postoperative bleeding after esophagectomy for esophageal cancer. Thus, when patients receive perioperative antiplatelet/anticoagulation treatment, careful attention is required after esophagectomy due to their increased risk of postoperative bleeding.

摘要

背景: 本研究的目的是评估围手术期使用抗血小板/抗凝治疗对食管癌术后出血的临床影响。 患者和方法: 患者选自 2005年1月至 2018年9月在横滨城市大学接受完全切除的连续患者的病历。将患者分为抗血小板/抗凝治疗组和非治疗组。比较两组食管癌切除术的安全性和可行性。 结果: 本研究对 102 例食管癌患者进行了食管切除术和分析。其中 18 例 (14.8%) 接受抗栓治疗 (抗凝组)。患者总体术后出血发生率为 8.2% (10/122)。抗凝组术后出血发生率为 22.2% (4/18),未抗凝组为 5.8% (6/104)。术前抗凝治疗被确定为术后出血的显著独立危险因素 (风险比 = 4.673,95% 可信区间 = 1.170-18.519; p = 0.029)。 结论: 围术期应用抗栓治疗是食管癌术后出血的重要危险因素。因此,当患者接受围手术期抗血小板/抗凝治疗时,由于术后出血风险增加,食管切除术后需要仔细关注。

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影响因子:1.24
发表时间:2020-01-01
DOI:10.3892/etm.2019.8190
作者列表:["Shang L","Pei QS","Xu D","Liu JY","Liu J"]

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影响因子:2.64
发表时间:2020-01-01
DOI:10.1007/s11605-019-04456-x
作者列表:["Campos VJ","Mazzini GS","Juchem JF","Gurski RR"]

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