کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6252956 1612239 2013 10 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Original scientific articleDoes Antiplatelet Therapy Affect Outcomes of Patients Receiving Abdominal Laparoscopic Surgery? Lessons from more than 1,000 Laparoscopic Operations in a Single Tertiary Referral Hospital
ترجمه فارسی عنوان
مقاله علمی اصلی آیا درمان ضد آنفولانزای ناشی از نتایج بیماران دریافت جراحی لاپاروسکوپی شکم است؟ درس های بیش از 1000 عملیات لاپاروسکوپی در یک بیمارستان مرجع تک ثانویه
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی عمل جراحی
چکیده انگلیسی

BackgroundThe effect of antiplatelet therapy (APT) on surgical blood loss and perioperative complications in patients receiving abdominal laparoscopic surgery still remains unclear.Study DesignA total of 1,075 consecutive patients undergoing abdominal laparoscopic surgery between 2005 and 2011 were reviewed. Our perioperative management protocol consisted of interruption of APT 1 week before surgery and early postoperative reinstitution in low thromboembolic risk patients (n = 160, iAPT group). Preoperative APT was maintained in patients with high thromboembolic risk or emergent situation (n = 52, cAPT group). Perioperative and outcomes variables of cAPT and iAPT groups, including bleeding and thromboembolic complications, were compared with those of patients without APT (non-APT group, n = 863).ResultsIn this cohort, 715 basic and 360 advanced laparoscopic operations were included. No patient suffering excessive intraoperative bleeding due to continuation of APT was observed. There were 10 postoperative bleeding complications (0.9%) and 3 thromboembolic events (0.3%), but the surgery was free of both complications in the cAPT group. No significant differences were found between the groups in operative blood loss, blood transfusion rate, and the occurrence of bleeding and thromboembolic complications. Multivariable analyses showed that multiple antiplatelet agents (p = 0.015) and intraoperative blood transfusion (p = 0.046) were significant prognostic factors for postoperative bleeding complications. Increased thromboembolic complications were independently associated with high New York Heart Association class (p = 0.019) and history of cerebral infarction (p = 0.048), but not associated with APT use.ConclusionsAbdominal laparoscopic operations were successfully performed without any increase in severe complications in patients with APT compared with the non-APT group under our rigorous perioperative assessment and management. Maintenance of single APT should be considered in patients with high thromboembolic risk, even when an abdominal laparoscopic approach is considered.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of the American College of Surgeons - Volume 217, Issue 6, December 2013, Pages 1044-1053
نویسندگان
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