Perioperative Management of Anticoagulation and Antiplatelet Therapy in Gastrointestinal Surgery

Abstract

Background: Agrowing number of patients are taking oral anticoagulant or antiplatelet drugs for primary or secondary prevention of arterial or venous thrombosis. Aims: The aim of this study is to study different types and uses of antiplatelet and anticoagulant therapy and to discuss the hazard and different challenges in perioperative management of patient on antiplatelet and anticoagulation therapy undergoing gastrointestinal surgery. Methodology: Perioperative management of the risks of hemorrhage and thrombosis related to gastrointestinal surgery tailored to patient characteristics are part of daily multidisciplinary practice tasks. The goal of this work is to discuss of different types and uses of antiplatelet and anticoagulant agents and to discuss current practices concerning antithrombosis prophylaxis and different challenges in perioperative management of patient on antiplatelet and anticoagulation therapy undergoing gastrointestinal surgery. Conclusion: The duration of prophylaxis is 1 month for oncological surgery. The recommended doses in bariatric surgery are twice daily injections of low-molecular weight heparin without exceeding a total dose of 10,000 IU/day. Dual antiplatelet therapy is necessary for 6 weeks after placement of bare-metal stents, from 6—12 months for drug-eluting stents, and 12 months after an acute coronary artery syndrome. Keywords: Perioperative Management, Anticoagulation, Antiplatelet Therapy, Gastrointestinal Surgery