Safety of Perioperative Maintenance of Antiplatelet Agents in Elderly Patients Undergoing Lung Cancer Surgery.

Q4 Medicine
Journal of Chest Surgery Pub Date : 2024-07-05 Epub Date: 2024-03-13 DOI:10.5090/jcs.23.155
Hee Ju Hong, Ji Hyeon Park, Samina Park, In Kyu Park, Chang Hyun Kang, Young Tae Kim
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引用次数: 0

Abstract

Background: The maintenance of antiplatelet therapy increases the risk of bleeding during lung cancer surgery. Conversely, the perioperative interruption of antiplatelet therapy may result in serious thrombotic complications. This study aimed to investigate the safety of continuing antiplatelet therapy in the context of lung cancer surgery.

Methods: We retrospectively reviewed a cohort of 498 elderly patients who underwent surgery for lung cancer. These patients were categorized into 2 groups: group N, which did not receive antiplatelet therapy, and group A, which did. Group A was subsequently subdivided into group Am, where antiplatelet therapy was maintained, and group Ai, where antiplatelet therapy was interrupted. We compared the incidence of bleeding-related and thrombotic complications across the 3 groups.

Results: There were 387 patients in group N and 101 patients in group A (Ai: 70, Am: 31). No significant differences were found in intraoperative blood loss, thoracotomy conversion rates, transfusion requirements, volume of chest tube drainage, or reoperation rates for bleeding control between groups N and A or between groups Am and Ai. The duration of hospital stay was longer for group A compared to group N (7 days vs. 6 days, p=0.005), but there was no significant difference between groups Ai and Am. The incidence of cardiovascular or cerebrovascular complications did not differ significantly between groups Ai and Am. However, group Ai included a severe case of in-hospital ST-elevation myocardial infarction.

Conclusion: The maintenance of antiplatelet therapy was found to be safe in terms of perioperative bleeding and thrombotic complications in elderly lung cancer surgery patients.

肺癌手术老年患者围手术期维持使用抗血小板药物的安全性
背景:维持抗血小板治疗会增加肺癌手术中出血的风险。相反,围手术期中断抗血小板治疗可能会导致严重的血栓性并发症。本研究旨在探讨肺癌手术中继续使用抗血小板疗法的安全性:我们对 498 名接受肺癌手术的老年患者进行了回顾性研究。这些患者被分为两组:未接受抗血小板治疗的 N 组和接受抗血小板治疗的 A 组。随后,A 组又被细分为维持抗血小板治疗的 Am 组和中断抗血小板治疗的 Ai 组。我们比较了三组中出血相关并发症和血栓并发症的发生率:N组有387名患者,A组有101名患者(Ai:70,Am:31)。N 组和 A 组之间以及 Am 组和 Ai 组之间在术中失血量、开胸手术转换率、输血需求、胸导管引流量或控制出血的再次手术率方面均无明显差异。与 N 组相比,A 组的住院时间更长(7 天对 6 天,P=0.005),但 Ai 组和 Am 组之间没有显著差异。心血管或脑血管并发症的发生率在 Ai 组和 Am 组之间没有显著差异。然而,Ai组中有一例严重的ST段抬高型心肌梗死病例:结论:就老年肺癌手术患者围术期出血和血栓并发症而言,维持抗血小板治疗是安全的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Chest Surgery
Journal of Chest Surgery Medicine-Surgery
CiteScore
0.80
自引率
0.00%
发文量
76
审稿时长
7 weeks
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