The Safety Assessment of Continuation of Perioperative Antiplatelet Therapy in Elective Robotic Surgery for...

Robotic surgery under condition of maintaining perioperative antiplatelet therapy (APT) is considered to have the risk of perioperative hemorrhagic events. We examined whether perioperative continuation of APT increased intraoperative blood loss and incidence of hemorrhagic complications in robot-assisted colorectal resection.

The medical records of patients who underwent robotic surgical resection of colorectal cancer at our hospital between September 2020 and December 2023 were enrolled. Intraoperative blood loss, incidence of blood transfusion, and postoperative hemorrhagic complications were evaluated after dividing the study population into an APT group (patients receiving perioperative APT) and a non-APT group.

Twenty-seven patients were included in the APT group and 65 patients were the non-APT group. All patients in the APT group were continued aspirin monotherapy until the day before the surgery. There were more anticoagulated patients in the non-APT group than in the APT-group (27.7% vs. 7.4%, p = 0.0496). Median intraoperative blood loss in the APT and non-APT group were 14 and 15 mL, respectively (p = 0.802). The incidence of intraoperative blood transfusion and postoperative hemorrhagic complication in the respective group were 0% and 4.6% (p = 0.553) and 0% and 1.5% (p = 1.00).

The results of this study suggested that perioperative continuation of APT will be allowed in robot-assisted colorectal resection in terms of safety.