Evidence map›Paper›PMID 39681683›Full record

ArticleSurgical endoscopy2025

The effect of anticoagulation therapy on the surgical outcomes of minimally invasive major gastrointestinal surgery.

Kei Harada, Yusuke Uemoto, Keiji Nagata, Taisuke Matsuoka, Ippei Yamana, Toshifumi Watanabe, Yuichiro Kawamura, Takahisa Fujikawa

Abstract read
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Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kei HaradaDepartment of Surgery, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-Ku, Kitakyushu, Fukuoka, 802-8555, Japan. kei228525@gmail.com.ORCID 0009-0000-3601-4955
Yusuke UemotoDepartment of Surgery, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-Ku, Kitakyushu, Fukuoka, 802-8555, Japan.
Keiji NagataDepartment of Surgery, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-Ku, Kitakyushu, Fukuoka, 802-8555, Japan.
Taisuke MatsuokaDepartment of Surgery, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-Ku, Kitakyushu, Fukuoka, 802-8555, Japan.
Ippei YamanaDepartment of Surgery, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-Ku, Kitakyushu, Fukuoka, 802-8555, Japan.
Toshifumi WatanabeDepartment of Surgery, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-Ku, Kitakyushu, Fukuoka, 802-8555, Japan.
Yuichiro KawamuraDepartment of Surgery, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-Ku, Kitakyushu, Fukuoka, 802-8555, Japan.
Takahisa FujikawaDepartment of Surgery, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-Ku, Kitakyushu, Fukuoka, 802-8555, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe surgical outcomes of minimally invasive surgery (MIS) for gastrointestinal (GI) cancers in patients receiving anticoagulation therapy (ACT) are unknown. We investigated the effect of ACT on the surgical outcomes of minimally invasive major GI surgery, with a particular focus on postoperative bleeding and thromboembolic complications.

methodsA total of consecutive 1290 patients undergoing elective minimally invasive (laparoscopic and robotic) major GI surgery (esophagogastric and colorectal resection for malignancy) between 2014 and 2023 were enrolled. The patients were divided into three groups: patients without receiving anticoagulation therapy (non-ACT, n = 1076), patients receiving direct oral anticoagulants (DOAC, n = 144), and patients receiving warfarin (WF, n = 70). Outcome variables were compared between the groups and the risk factors of postoperative bleeding complications were assessed using logistic multivariate analysis.

resultsThe overall rate of thromboembolic complication was 0.5%, and the operative mortality was zero in the whole cohort. The incidences of postoperative bleeding in the non-ACT, DOAC, and WF groups were 1.0%, 6.9% and 11.4%, respectively (P < 0.001). Among 8 DOAC-received patients with postoperative GI bleeding, 75% of cases occurred on postoperative day 5 or later. Multivariate analysis showed DOAC (odds ratio = 5.420, P < 0.001) and perioperative heparinization (odds ratio = 3.770, P = 0.048) were significant risk factors for major postoperative bleeding.

conclusionsAlthough minimally invasive major GI surgery can be safely performed in patients receiving ACT, attention should be paid for the occurrence of delayed GI bleeding especially in the DOAC-received patients. Patients treated with DOAC or perioperative heparinization still represent a challenging group in the present cohort, and need to be carefully managed.

Indexed as

AnticoagulantsGastrointestinal NeoplasmsLaparoscopyPostoperative HemorrhageRobotic Surgical ProceduresThromboembolismAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsTreatment OutcomeWarfarinAnticoagulantsWarfarinAnticoagulation therapyDirect oral anticoagulantsGastrointestinal surgeryLaparoscopic surgeryMinimally invasive surgeryRobotic surgery

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.