Effects of antithrombotic agents on post-operative bleeding after endoscopic resection of gastrointestinal neoplasms and polyps:A systematic review and meta-analysis

• 作者: Bing-Jie Xiang Cong Dai Min Jiang Yu-Hong Huang
• 来源期刊: 世界荟萃分析杂志
• 学科: 医学
• 关键词: Endoscopic resection ANTITHROMBOTIC ANTICOAGULANTS Postoperative bleeding Endoscopic mucosal resection Endoscopic submucosal dissection
• 年，卷（期）: 2020,（5）
• 页码范围: 411-434
• 页数: 24页
• 分类号: R57

摘要

BACKGROUND There are some studies investigating the relationship between antithrombotic medication and postoperative bleeding after endoscopic resection(ER)with controversial results.AIM To perform a meta-analysis evaluating the effects of antithrombotic therapy on postoperative bleeding after ER.METHODS A systematic search was conducted on PubMed,Web of Science,Cochrane Library.The Newcastle-Ottawa scale was used to evaluate the quality of studies.Stata 12.0 was used for statistical analysis.The odds ratio(OR)and 95%CI were calculated and heterogeneity was quantified using Cochran’s Q test and I2.RESULTS Total 66 studies were included in the meta-analysis.Pooled data suggested that antithrombotic therapy was significantly associated with postoperative bleeding(OR=2.302,95%CI:2.057-2.577,P=0.000)after ER.The risk of postoperative bleeding after endoscopic submucosal dissection,endoscopic mucosal resection and polypectomy in the antithrombotic group was higher than the nonantithrombotic group(OR=2.439,95%CI:1.916-3.105;OR=2.688,95%CI:1.098-6.582;OR=2.112,95%CI:1.434-3.112).CONCLUSION The risk of postoperative bleeding after ER correlated with the types and management of antithrombotic agents by our meta-analysis.