title: [Thrombotic and Bleeding Risks of Patients on Antiplatelet Therapy Undergoing Major Abdominal Malignancy Surgery].
abstract: BACKGROUND
  Controversies still exist whether to continue or withdraw aspirin (ASA) perioperatively. This study was performed to determine whether patients on preoperative antiplatelet therapy (APT) benefit from continuing ASA in terms of thrombotic and bleeding risk prevention.
  
  
  METHODS
  Among 307 consecutive patients who were on APT preoperatively for the secondary prevention of cardiovascular disease and who underwent elective major abdominal malignancy surgery, 148 patients had all the preoperative APT withdrawn and the remaining 159 patients continued only ASA. Comparisons were made between the 2 groups regarding the rate and the amount of exogenous blood transfusion as well as the incidence of thromboembolic events (TEEs) within 1 month after surgery.
  
  
  RESULTS
  The incidence of perioperative TEEs of the APT withdrawn group was significantly higher than that of the ASA group (6.2% vs 0%, P = 0.005), while the rate and the amount of exogenous blood transfusion were not different each other (23.6% vs 17.0%, P = 0.146 and 4 units vs 4 units, P = 0.544, respectively).
  
  
  CONCLUSIONS
  Considering the relatively low bleeding risk when continued and the increased thrombotic risk after withdrawal, ASA should be continued perioperatively in patients undergoing major abdominal malignancy surgery.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Ono
authors.forename: Hidekuni
authors.initials: H
authors.lastname: Hidaka
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Koyama
authors.forename: Kenzou
authors.initials: K
authors.lastname: Ishii
authors.forename: Chiharu
authors.initials: C
authors.lastname: Tanaka
authors.forename: Shinya
authors.initials: S
authors.lastname: Taguchi
authors.forename: Nobuki
authors.initials: N
authors.lastname: Okazaki
authors.forename: Wakana
authors.initials: W
authors.lastname: Tanimoto
authors.forename: Akira
authors.initials: A
authors.lastname: Katayama
mesh_terms: D000008:Abdominal Neoplasms / Q000601:surgery*; D000368:Aged; D001803:Blood Transfusion; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D012306:Risk; D013927:Thrombosis / Q000517:prevention & control*
chemical_list: D010975:Platelet Aggregation Inhibitors