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

[BACKGROUND/AIM] 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 AND METHODS] 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.

[RESULTS] 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% . 21.7%, <0.001) (1.7% . 0.5%, =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; =0.002) and postoperative bleeding in both univariate and multivariate analyses (OR=3.328; =0.049).

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