Impacts on Postoperative Bleeding of Surgery for Head and Neck Malignancies While Continuing Antithrombotic Agents

Introduction  Perioperative management of antithrombotic agents may affect bleeding and lead to thromboembolic complications, but there is no consensus on optimal protocol in head and neck surgery. Objective  To explore the effect of antithrombotic agents on postoperative bleeding. Methods  We compared clinical characteristics, type of surgery, antithrombotic agents, continued use of medication or not, and frequency of postoperative bleeding among patients who were receiving antithrombotic therapy at the time of their decision to undergo surgery for head and neck malignancies, from 2008 to 2022. Results  A total of 168 patients were included. There was no significant difference in the incidence of intraoperative blood loss or postoperative bleeding between the group that underwent surgery while on antithrombotic therapy and those that underwent surgery after antithrombotic therapy was discontinued. In particular, there was no increase in bleeding complications with antiplatelet agents, regardless of the type or number of agents used. Conclusion  Surgery for head and neck malignancies with continued antiplatelet therapy may not increase bleeding complications, regardless of the type of antiplatelet therapy and even when multiple agents are taken.