期刊
COLORECTAL DISEASE
卷 14, 期 12, 页码 1516-1520出版社
WILEY-BLACKWELL
DOI: 10.1111/j.1463-1318.2012.03063.x
关键词
Anticoagulants; acetylsalicylic acid; clopidogrel; haemorrhage; haemorrhoids; surgery
Aim This prospective observation study evaluated the incidence of secondary bleeding after proctological surgery without interruption of oral anticoagulant or platelet-inhibitor treatments. Method The number of episodes of postoperative bleeding was identified prospectively from the day of surgery to the last follow-up visit in consecutive patients operated on during 2010 in two units dedicated to proctology. Results A total of 2513 procedures were performed in 2314 patients (1379 men), 46 +/- 16 years of age. Secondary bleeding occurred after 115 (4.6%) procedures, no later than day 24 after surgery, requiring rehospitalization in 86% of cases and further surgery and/or transfusion in 36%. The highest frequency was noted after surgery for haemorrhoids (haemorrhoidopexy, 7.9%; haemorrhoidectomy, 6.2%) (P = NS and transanal excision of rectal tumours (6.5%). On multivariate analysis, the frequency was significantly increased by clopidogrel (15%) [relative risk (RR) = 10). In patients on oral anticoagulants, bleeding occurred in 23% (RR = 5.8) if the anticoagulants were not interrupted and in 57% (RR = 42) if the anticoagulants were discontinued and replaced with heparin. Conclusion During proctological surgery the overall risk of postoperative bleeding is low, but it can occur up to 3 weeks after surgery and is often severe. Maintenance treatment with oral anticoagulants is the most important risk factor, aggravated by a change to heparin. Clopidogrel also significantly increases the bleeding risk.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据