Key result
Long-term anti-thrombotic therapy resulted in similar estimated blood loss (median 50 mL vs 20 mL) and operative time (294 min vs 295 min) compared to no therapy during laparoscopic surgery.
Why the study?
The safety and efficacy of laparoscopic resection for rectal cancer in patients receiving long-term anti-thrombotic therapy remained unclear.
Does long-term anti-thrombotic therapy affect surgical outcomes in patients undergoing laparoscopic resection for rectal cancer?
Cohort (n=364)
No
Does long-term anti-thrombotic therapy affect surgical outcomes in patients undergoing laparoscopic resection for rectal cancer?
Laparoscopic surgery for rectal cancer appears safe and feasible for patients on long-term anti-thrombotic therapy when discontinued perioperatively.
May support continuing anti-thrombotic therapy in laparoscopic surgery; leaves open prospective validation.
Background: Several previous studies have shown that laparoscopic resection of rectal cancer is a feasible option. However, its safety and efficacy in patients receiving long-term anti-thrombotic therapy (AT) remain unclear.Material and methods: We retrospectively reviewed 364 patients who underwent elective resection for rectal cancer via a laparoscopic approach between 2007 and 2018 in our institute. Patients were classified according to the long-term use of AT. AT was interrupted perioperatively with or without heparin bridging therapy in all anti-thrombotic users. Clinicopathological factors and surgical outcomes were analyzed between patient groups.Results: Thirty-two patients (9%) receiving AT were older and had lower albumin and hemoglobin levels than those not receiving AT (the non-AT group), and were predominantly male. Estimated blood loss and operative time in the AT group (median: 50 mL and 294 min) did not differ from those in the non-AT group (median: 20 mL and 295 min). There were no intergroup differences in the frequencies of other postoperative complications and oncological outcomes.Conclusions: Our results at the very least can support that laparoscopic surgery for rectal cancer is a safe and feasible option for patients taking long-term AT discontinued perioperatively.
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Nozawa et al. (2019) conducted a cohort in Rectal cancer (n=364). Long-term anti-thrombotic therapy vs. No anti-thrombotic therapy was evaluated on Estimated blood loss and operative time. Long-term anti-thrombotic therapy resulted in similar estimated blood loss (median 50 mL vs 20 mL) and operative time (294 min vs 295 min) compared to no therapy during laparoscopic surgery.
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