Postoperative Bleeding After Gastrectomy for Gastric Cancer in Patients Receiving Antiplatelet and/or Anticoagulation...

This study retrospectively evaluated the clinical impact of perioperative antiplatelet and/or anticoagulation therapy (hereafter: antiplatelet/anticoagulation therapy) in more than 2,000 patients with gastric cancer (GC) who underwent gastrectomy.

Patients were selected from the consecutive database of Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Department of Gastric Surgery, between 2005 and 2025. Grade 2-5 postoperative complications (according to the Clavien-Dindo classification) were retrospectively determined from the patients' records.

We analyzed 2,023 patients who underwent gastrectomy for GC. Among the 2,023 patients, 229 (11.3%) received antiplatelet and/or anticoagulation therapy. The rates of postoperative surgical complications and postoperative bleeding were significantly higher in the antiplatelet/anticoagulation therapy group than in the non-antiplatelet/anticoagulation therapy group (34.1% vs. 21.7%, p<0.001) (1.7% vs. 0.5%, p=0.026). Risk factors for postoperative surgical complications and bleeding were analyzed based on perioperative factors using logistic regression analysis. Preoperative antiplatelet/anticoagulation therapy was identified as a significant independent risk factor for postoperative surgical complications [odds ratio (OR)=1.651; p=0.002) and postoperative bleeding in both univariate and multivariate analyses (OR=3.328; p=0.049).

Patients with gastric cancer treated with perioperative antiplatelet and/or anticoagulation treatment require careful attention for postoperative surgical complications, including postoperative bleeding after gastrectomy.