Journal of Nihon University Medical Association
Online ISSN : 1884-0779
Print ISSN : 0029-0424
ISSN-L : 0029-0424
Original Article:
The Influence of Preoperative Antithrombotic Therapy in Patients with Thoracic Surgery
Motohiko Furuichi, Kiminobu Sugito, Mie Shimamura, Tatsuhiko Nishii, Shinji Takeshita, Shinichirou Ishimoto, Youko Tanaka, Hiroaki Morooka, Ryouta Higure, Motomi Shiono
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Keywords: antithrombotic therapy, respiratory surgery, noncardiac surgery, perioperative heparinization
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2014 Volume 73 Issue 6 Pages 248-253

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Abstract
During the course of 4 years and 8 months, from January 2009 to August 2013, 737 patients underwent surgery with general anesthesia at our department. Perioperative heparinization was required in 28 of these patients (3.8%) because they had been treated with antithrombotic therapy prior to the operation. Oral antithrombotic agents were discontinued as part of the perioperative management after the patients had been hospitalized for one week prior to surgery, and the activated partial thromboplastin time was controlled at around 55-70 seconds with continuous intravenous administration of unfractionated heparin. The intravenous heparin administration was discontinued 6 hours before surgery. In all patients, surgery was performed safely, and oral medications were resumed on postoperative day 1. There were no significant differences in the operative time or blood loss between the heparinization and control groups. Among 316 patients with resectable malignant tumors of the lung, 20 (6.3%) received antithrombotic therapy before surgery. In the heparinization group, a significantly prolonged operative time was observed, but there was no significant increase in blood loss or the postoperative hospitalization period. These observations suggest that surgery with perioperative heparinization in patients receiving antithrombotic therapy can be performed safely similar to routine surgery.
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© 2014 The Nihon University Medical Association
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