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Im C, Park YS, Min SH, Kang SH, Lee S, Lee E, Yoo M, Hwang D, Ahn SH, Suh YS, Park DJ, Kim HH. Postoperative major bleeding risk in patients using oral antiplatelets and/or anticoagulants after laparoscopic gastric cancer surgery. Ann Surg Treat Res 2023; 104:80-89. [PMID: 36816732 PMCID: PMC9929431 DOI: 10.4174/astr.2023.104.2.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/16/2022] [Accepted: 12/05/2022] [Indexed: 02/09/2023] Open
Abstract
Purpose The use of antiplatelet and/or anticoagulant therapies has become common. In rare cases, these therapies may increase the risk of dangerous postoperative bleeding. We investigated the association of antiplatelets and/or anticoagulants with postoperative major bleeding risk in laparoscopic gastric cancer surgery. Methods We retrospectively enrolled 3,663 gastric cancer patients (antiplatelet/anticoagulant group, 518; control group, 3,145) who had undergone laparoscopic surgery between January 2012 and December 2017. To minimize selection bias, 508 patients in each group were matched using propensity score matching (PSM) method. The primary outcome was postoperative major bleeding. Secondary outcomes were intraoperative, postoperative transfusion and early complications. Results After PSM, postoperative major bleeding occurred in 10 (2.0%) and 3 cases (0.6%) in the antiplatelets/anticoagulants and control groups, respectively (P = 0.090). Intraoperative and postoperative transfusions were not significantly different between 2 groups (2.4% vs. 1.4%, P = 0.355 and 5.5% vs. 4.3%, P = 0.469). Early complications developed in 58 (11.4%) and 43 patients (8.5%) in the antiplatelets/anticoagulants and control groups, respectively (P = 0.142). The mean amounts of intraoperative and postoperative transfusions were not significantly different between the groups (366.67 ± 238.68 mL vs. 371.43 ± 138.01 mL, P = 0.962; 728.57 ± 642.25 mL vs. 508.09 ± 468.95 mL, P = 0.185). In multivariable analysis, male (P = 0.008) and advanced stage (III, IV) (P = 0.024) were independent significant risk factors for postoperative major bleeding. Conclusion Preoperative antiplatelets and/or anticoagulants administration did not significantly increase the risk of postoperative major bleeding after laparoscopic gastric cancer surgery.
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Affiliation(s)
- Chami Im
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young Suk Park
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sa-Hong Min
- Department of Surgery, Asan Medical Center, Seoul, Korea
| | - So Hyun Kang
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sangjun Lee
- Department of Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Eunju Lee
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Mira Yoo
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Duyeong Hwang
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sang-Hoon Ahn
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yun Suhk Suh
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Do Joong Park
- Department of Surgery, Seoul National University Hospital, Seoul, Korea.,Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyung-Ho Kim
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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Gao J, Ren W, Xiao C, Wang L, Huang Q, Zhang Z, Dang Y, Weng P, Wang H, Fang X, Zhuang M, Lin L, Chen S. Involvement of SLC39A6 in gastric adenocarcinoma and correlation of the SLC39A6 polymorphism rs1050631 with clinical outcomes after resection. BMC Cancer 2019; 19:1069. [PMID: 31703635 PMCID: PMC6839152 DOI: 10.1186/s12885-019-6222-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/30/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The single-nucleotide polymorphism SLC39A6 rs1050631 is strongly implicated in esophageal squamous cell carcinoma, leading us to question whether it may also play a role in gastric adenocarcima (GA). METHODS We genotyped the SLC39A6 rs1050631 in 512 patients who underwent GA resection. All study subjects lived in an area of China with high GA incidence. Genotypes were examined for possible correlation with survival and recurrence. The potential involvement of SLC39A6 in gastric cancer was explored in clinical samples and cell culture studies. RESULTS Multivariable analysis showed that patients with the CT + TT genotype at SLC39A6 rs1050631 were at greater risk of recurrence (hazard ratio, HR 1.387, p = 0.004) and death (HR 1.429, p = 0.002) than patients with CC genotype. Median recurrence-free and overall survival were significantly shorter in patients with the CT + TT genotype (20, 27 months) than in patients with the CC genotype (36, 43 months, p = 0.001, p < 0.001). Patients with the CT + TT genotype who were male or ≥ 60 years, or who had a tumor ≥5 cm or a moderately differentiated tumor were at significantly higher risk of recurrence and death. SLC39A6 was overexpressed in tissues from GA patients and in GA cell lines, and SLC39A6 knockdown in GA cell lines inhibited their proliferation, migration and invasion. CONCLUSION SLC39A6 rs1050631 correlates with post-resection prognosis of GA patients and SLC39A6 may participate in GA onset or progression.
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Affiliation(s)
- Jian Gao
- Department of General Surgery, Dongfang Hospital (900 Hospital of the Joint Logistics Team), 156 North Xi-er Huan Road, Fuzhou, 350025, Fujian, China
| | - Wenjun Ren
- Department of General Surgery, Dongfang Hospital (900 Hospital of the Joint Logistics Team), 156 North Xi-er Huan Road, Fuzhou, 350025, Fujian, China
| | - Chunhong Xiao
- Department of General Surgery, Dongfang Hospital (900 Hospital of the Joint Logistics Team), 156 North Xi-er Huan Road, Fuzhou, 350025, Fujian, China.,China Clinical Institute of Fuzhou General Hospital (900 Hospital of the Joint Logistics Team), Fujian Medical University, 156 North Xi-er Huan Road, Fuzhou, 350025, Fujian, China
| | - Lie Wang
- Department of General Surgery, Dongfang Hospital (900 Hospital of the Joint Logistics Team), 156 North Xi-er Huan Road, Fuzhou, 350025, Fujian, China.,China Clinical Institute of Fuzhou General Hospital (900 Hospital of the Joint Logistics Team), Fujian Medical University, 156 North Xi-er Huan Road, Fuzhou, 350025, Fujian, China
| | - Qiaojia Huang
- Department of Experimental Medicine, Dongfang Hospital (900 Hospital of the Joint Logistics Team), 156 North Xi-er Huan Road, Fuzhou, 350025, Fujian, China
| | - Zaizhong Zhang
- Department of General Surgery, Dongfang Hospital (900 Hospital of the Joint Logistics Team), 156 North Xi-er Huan Road, Fuzhou, 350025, Fujian, China.,China Clinical Institute of Fuzhou General Hospital (900 Hospital of the Joint Logistics Team), Fujian Medical University, 156 North Xi-er Huan Road, Fuzhou, 350025, Fujian, China
| | - Yuan Dang
- Fujian Meiya Aijiankang Health Management Co, Ltd. 4602#, Building 1, Shimao International Center, 108 Guangda Road, Fuzhou, 350025, Fujian, China
| | - Pengcheng Weng
- Union Medical College, Fujian Medical University, 29 XinQuan Road, Fuzhou, 350025, Fujian, China
| | - Hui Wang
- Union Medical College, Fujian Medical University, 29 XinQuan Road, Fuzhou, 350025, Fujian, China
| | - Xuehong Fang
- Union Medical College, Fujian Medical University, 29 XinQuan Road, Fuzhou, 350025, Fujian, China
| | - Minxian Zhuang
- Union Medical College, Fujian Medical University, 29 XinQuan Road, Fuzhou, 350025, Fujian, China
| | - Liying Lin
- Department of General Surgery, Dongfang Hospital (900 Hospital of the Joint Logistics Team), 156 North Xi-er Huan Road, Fuzhou, 350025, Fujian, China. .,China Clinical Institute of Fuzhou General Hospital (900 Hospital of the Joint Logistics Team), Fujian Medical University, 156 North Xi-er Huan Road, Fuzhou, 350025, Fujian, China.
| | - Shaoquan Chen
- Department of General Surgery, Dongfang Hospital (900 Hospital of the Joint Logistics Team), 156 North Xi-er Huan Road, Fuzhou, 350025, Fujian, China. .,China Clinical Institute of Fuzhou General Hospital (900 Hospital of the Joint Logistics Team), Fujian Medical University, 156 North Xi-er Huan Road, Fuzhou, 350025, Fujian, China.
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