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Published in: Surgery Today 12/2014

01-12-2014 | Original Article

Feasibility of aspirin continuation during the perioperative period for pulmonary resection in lung cancer patients: a retrospective study at a single institute in Japan

Authors: Ryu Kanzaki, Masayoshi Inoue, Masato Minami, Yasushi Shintani, Tomoyuki Nakagiri, Soichiro Funaki, Noriyoshi Sawabata, Meinoshin Okumura

Published in: Surgery Today | Issue 12/2014

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Abstract

Purpose

To evaluate the feasibility of aspirin continuation during the perioperative period for pulmonary resection in lung cancer patients.

Methods

A retrospective study was conducted in 46 patients who were taking aspirin and underwent pulmonary resection. The indications for aspirin were generally a cardiovascular or cerebrovascular comorbidity. Whether to continue or discontinue aspirin was determined based on the severity of the cardiovascular or cerebrovascular comorbidity, along with the patient’s overall condition. The intraoperative and postoperative outcomes were compared between patients continuing and those discontinuing aspirin.

Results

Twenty patients continued (group C) and 26 patients discontinued (group D) aspirin. The length of the operation (226 ± 97 min in group C vs. 189 ± 90 min in group D), intraoperative bleeding (234 ± 232 vs. 204 ± 367 g) and average pleural discharge on postoperative days 1, 2 and 3 (331, 230 and 215 vs. 304, 210 and 174 ml/day) showed no significant differences between the two groups. The postoperative complication rates were also not significantly different between the two groups [eight patients (40 %) in group C vs. nine patients (35 %) in group D].

Conclusions

Continuous administration of aspirin during the perioperative period for pulmonary resection in lung cancer patients appears to be clinically feasible in the Japanese population.
Literature
1.
go back to reference Endo H, Yamamoto R, Satoh Y, Kuwano H, Nishizawa N. Risk analysis of pulmonary resection for elderly patients with lung cancer. Surg Today. 2013;43:514–20.CrossRef Endo H, Yamamoto R, Satoh Y, Kuwano H, Nishizawa N. Risk analysis of pulmonary resection for elderly patients with lung cancer. Surg Today. 2013;43:514–20.CrossRef
2.
go back to reference Antithrombotic Trialists’ Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ. 2002;324:71–86.CrossRef Antithrombotic Trialists’ Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ. 2002;324:71–86.CrossRef
3.
go back to reference McFadden EP, Stabile E, Regar E, Cheneau E, Ong AT, Kinnaird T, et al. Late thrombosis in drug-eluting coronary stents after discontinuation of antiplatelet therapy. Lancet. 2004;364:1519–21.PubMedCrossRef McFadden EP, Stabile E, Regar E, Cheneau E, Ong AT, Kinnaird T, et al. Late thrombosis in drug-eluting coronary stents after discontinuation of antiplatelet therapy. Lancet. 2004;364:1519–21.PubMedCrossRef
4.
go back to reference Sonobe M, Sato T, Chen F, Fujinaga T, Shoji T, Sakai H, et al. Management of patients with coronary stents in elective thoracic surgery. Gen Thorac Cardiovasc Surg. 2011;59:477–82.PubMedCrossRef Sonobe M, Sato T, Chen F, Fujinaga T, Shoji T, Sakai H, et al. Management of patients with coronary stents in elective thoracic surgery. Gen Thorac Cardiovasc Surg. 2011;59:477–82.PubMedCrossRef
5.
go back to reference Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.PubMedCentralPubMedCrossRef Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.PubMedCentralPubMedCrossRef
6.
go back to reference Douketis JD, Berger PB, Dunn AS, Jaffer AK, Spyropoulos AC, Becker RC, et al. The perioperative management of antithrombotic therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edition). Chest. 2008;133:299S–339S.PubMedCrossRef Douketis JD, Berger PB, Dunn AS, Jaffer AK, Spyropoulos AC, Becker RC, et al. The perioperative management of antithrombotic therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edition). Chest. 2008;133:299S–339S.PubMedCrossRef
7.
go back to reference Fleisher LA, Beckman JA, Brown KA, Calkins H, Chaikof E, Fleischmann KE, et al. ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 2002 guidelines on perioperative cardiovascular evaluation for noncardiac surgery): developed in collaboration with the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery. Circulation. 2007;116:1971–96.PubMedCrossRef Fleisher LA, Beckman JA, Brown KA, Calkins H, Chaikof E, Fleischmann KE, et al. ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 2002 guidelines on perioperative cardiovascular evaluation for noncardiac surgery): developed in collaboration with the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery. Circulation. 2007;116:1971–96.PubMedCrossRef
8.
go back to reference Poldermans D, Bax JJ, Boersma E, De Hert S, Eeckhout E, Fowkes G, et al. Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery. Eur Heart J. 2009;30:2769–812.PubMedCrossRef Poldermans D, Bax JJ, Boersma E, De Hert S, Eeckhout E, Fowkes G, et al. Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery. Eur Heart J. 2009;30:2769–812.PubMedCrossRef
9.
go back to reference Saunders E, Ofili E. Epidemiology of atherothrombotic disease and the effectiveness and risks of antiplatelet therapy: race and ethnicity considerations. Cardiol Rev. 2008;16:82–8.PubMedCrossRef Saunders E, Ofili E. Epidemiology of atherothrombotic disease and the effectiveness and risks of antiplatelet therapy: race and ethnicity considerations. Cardiol Rev. 2008;16:82–8.PubMedCrossRef
10.
go back to reference Kobayashi H. Evaluation of the need to discontinue antiplatelet and anticoagulant medications before cataract surgery. J Cataract Refract Surg. 2010;36:1115–9.PubMedCrossRef Kobayashi H. Evaluation of the need to discontinue antiplatelet and anticoagulant medications before cataract surgery. J Cataract Refract Surg. 2010;36:1115–9.PubMedCrossRef
11.
go back to reference Shinkai A, Matsumoto Y, Chikuda M. Evaluation of patients undergoing vitreous surgery while on antithrombotic therapy (in Japanese with English abstract). Gannka Rinsho Kiyo (Folia Japonica de Ophthalmologica). 2011;4:433–6. Shinkai A, Matsumoto Y, Chikuda M. Evaluation of patients undergoing vitreous surgery while on antithrombotic therapy (in Japanese with English abstract). Gannka Rinsho Kiyo (Folia Japonica de Ophthalmologica). 2011;4:433–6.
12.
go back to reference Ohmiya H, Okajima K, Abe Y, Tanoue M, Murakami N, Mori S. Anticoagulant during perioperative stage of spinal surgery (in Japanese with English abstract). Orthop Traumatol. 2007;56:214–6.CrossRef Ohmiya H, Okajima K, Abe Y, Tanoue M, Murakami N, Mori S. Anticoagulant during perioperative stage of spinal surgery (in Japanese with English abstract). Orthop Traumatol. 2007;56:214–6.CrossRef
13.
go back to reference Murase A, Yoshida I, Shibata Y, Kawanishi T, Kojima H, Kuroyanagi H. A study of the continuation of aspirin in proximal femoral fracture patients (in Japanese). Central Jpn J Orthop Surg Traumatol. 2011;54:291–2. Murase A, Yoshida I, Shibata Y, Kawanishi T, Kojima H, Kuroyanagi H. A study of the continuation of aspirin in proximal femoral fracture patients (in Japanese). Central Jpn J Orthop Surg Traumatol. 2011;54:291–2.
14.
go back to reference Tsukahara A, Maruta T, Koyama S, Tanaka N, Takeda N, Shimoda S. Koukesshoubannryouhoushourei ni taisuru shoukakigekashujutu (in Japanese). In: Abstract of the 67th general meeting of the Japanese Society of Gastroenterological Surgery, pp 3–167. Tsukahara A, Maruta T, Koyama S, Tanaka N, Takeda N, Shimoda S. Koukesshoubannryouhoushourei ni taisuru shoukakigekashujutu (in Japanese). In: Abstract of the 67th general meeting of the Japanese Society of Gastroenterological Surgery, pp 3–167.
15.
16.
go back to reference Yokoyama M. Antiplatelet drug, anticoagulation therapy, and epidural anesthesia (in Japanese with English abstract). J Jpn Soc Clin Anesth. 2010;30:142–50.CrossRef Yokoyama M. Antiplatelet drug, anticoagulation therapy, and epidural anesthesia (in Japanese with English abstract). J Jpn Soc Clin Anesth. 2010;30:142–50.CrossRef
17.
go back to reference Liu SS, Wu CL. Effect of postoperative analgesia on major postoperative complications: a systematic update of the evidence. Anesth Analg. 2007;104:689–702.PubMedCrossRef Liu SS, Wu CL. Effect of postoperative analgesia on major postoperative complications: a systematic update of the evidence. Anesth Analg. 2007;104:689–702.PubMedCrossRef
18.
go back to reference Beattie WS, Badner NH, Choi PT. Meta-analysis demonstrates statistically significant reduction in postoperative myocardial infarction with the use of thoracic epidural analgesia. Anesth Analg. 2003;97:919–20.PubMedCrossRef Beattie WS, Badner NH, Choi PT. Meta-analysis demonstrates statistically significant reduction in postoperative myocardial infarction with the use of thoracic epidural analgesia. Anesth Analg. 2003;97:919–20.PubMedCrossRef
19.
go back to reference Kato K, Shinjo Y, Yoshikawa K, Yonei A. A case report of a DES-implanted patient: continuation of antiplatelet therapy would prevent stent thrombosis after surgery (in Japanese with English abstract). J Jpn Soc Clin Anesth. 2011;31:986–9.CrossRef Kato K, Shinjo Y, Yoshikawa K, Yonei A. A case report of a DES-implanted patient: continuation of antiplatelet therapy would prevent stent thrombosis after surgery (in Japanese with English abstract). J Jpn Soc Clin Anesth. 2011;31:986–9.CrossRef
20.
go back to reference Kimura T, Morimoto T, Nakagawa Y, Tamura T, Kadota K, Yasumoto H, et al. Antiplatelet therapy and stent thrombosis after sirolimus-eluting stent implantation. Circulation. 2009;119:987–95.PubMedCrossRef Kimura T, Morimoto T, Nakagawa Y, Tamura T, Kadota K, Yasumoto H, et al. Antiplatelet therapy and stent thrombosis after sirolimus-eluting stent implantation. Circulation. 2009;119:987–95.PubMedCrossRef
Metadata
Title
Feasibility of aspirin continuation during the perioperative period for pulmonary resection in lung cancer patients: a retrospective study at a single institute in Japan
Authors
Ryu Kanzaki
Masayoshi Inoue
Masato Minami
Yasushi Shintani
Tomoyuki Nakagiri
Soichiro Funaki
Noriyoshi Sawabata
Meinoshin Okumura
Publication date
01-12-2014
Publisher
Springer Japan
Published in
Surgery Today / Issue 12/2014
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-014-0843-2

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