Evaluation of surgery risk factor associated to antithrombotic therapy in patients who underwent colorectal surgery

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COD: 11_1164_2417 Categorie: ,

Paolo Del Rio, Francesco Sozzi, Elisa Bertocchi, Paolo Dell’Abate, Gennaro Perrone, Maria Francesca Arcuri, Mario Sianesi

Ann. Ital. Chir., 2016 87: 56-60

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BACKGROUND: Use of antiplatelet therapy in western people is common. The risk of bleeding related to surgical procedure
or invasive procedure is higher.We want to analyse the correlation between colorectal surgery, antiplatelet therapy
and postoperative surgical complications.
METHODS: We categorized: 176 cases treated for colorectal cancer and we recorded the following data: type of surgery,
body max index (BMI), haemoglobin value (Hb); preoperative prothrombin time (PT) and blood transfusions pre and
postoperative and during surgery. The analysis focused on two groups: patients who received antiplatelet therapy (AT –
antiplatelet therapy) and patients who didn’t receive this therapy (NAT – not antiplatelet therapy).
RESULTS: In the group of patients who underwent right emicolectomy, haemoglobin values were lower in patients who
received antithrombotic therapy than in patients who didn’t receive this therapy with a statistical significance (p < 0,05); the same datum resulted in patients who underwent left emicolectomy. Normal weight patients that received antiplatelet therapy had lower values of haemoglobin without statistical significance (p value not significant). Overweight patients who underwent therapy with antiplatelet agents had lesser Hb value than group that didn’t performed this therapy (p < 0,05). Patients who received AT showed a bigger percentage of blood transfusions regardless of type of surgery than the second group with statistical significance Normal weight patients showed a different incidence of blood transfusions between patients who underwent antiplatelet therapy (50%) and patients who didn’t receive this therapy (29%) with statistic significance (p < 0,05). Overweight patients didn’t present this significant difference. We analyzed the incidence of post-operative complications in normal weight patients and overweight patients and we showed that the incidence of complications, both minor and major, was higher in patients who underwent antiplatelet therapy than in the second group regardless of weight CONCLUSIONS: Antiplatelet therapy in patients who underwent invasive surgery changes the incidence of some risk factors, such as bleeding, and of post-operative complications. This result underlines the importance of careful handling and preparation in patients receiving antithrombotic agents that have to undergo invasive surgery.

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