Why the study?
Patients on antithrombotic therapy present conflicting perioperative risks of bleeding and thromboembolism, prompting the update of a hospital perioperative management guideline to incorporate direct oral anticoagulants.
This paper outlines an updated institutional protocol for managing perioperative antithrombotic therapy, including DOACs, to balance bleeding and thromboembolic risks during surgery.
Facilitates risk-balanced perioperative antithrombotic care including DOACs in GI surgery; extends institutional protocols to current evidence.
In patients taking antithrombotic therapy ( ATT ) , we have to manage two conflicting risks of bleeding and thromboembolism perioperatively. W e have established our ow n perioperative antithrombotic management protocol for ATT-burdened patients (“Kokura Protocol”), and b ased on th is protocol, the hospital guideline for gastroenterological and general surgery in patients re c eiving ATT was made and have been used. Thereafter, in consideration of newly launched anticoagulants called direct oral anticoagulants ( DOACs ) , the guideline has been updated with appendix on DOACs. In this paper, our current updated guideline concerning perioperative ATT management during GE and general surgery will be outline d.
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Takahisa Fujikawa (2020) conducted a review in Patients undergoing general and gastroenterological surgery while on antithrombotic therapy. Kokura Protocol 2019 (perioperative antithrombotic management) was evaluated. The updated Kokura Protocol 2019 outlines the hospital guideline for perioperative antithrombotic management, including direct oral anticoagulants, during gastroenterological and general surgery.
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