The impact of perioperative heparin bridging therapy in lung cancer surgery

Gen Thorac Cardiovasc Surg. 2020 Jun;68(6):623-628. doi: 10.1007/s11748-019-01276-3. Epub 2019 Dec 17.

Abstract

Purpose: The impact of perioperative heparin bridging (HB) for lung surgery in patients on anti-clotting drugs remains unclear. We performed a retrospective study to assess its effect on surgical safety by comparing HB and non-HB groups.

Methods: This study included 274 consecutive patients on anti-clotting drugs who underwent surgery for lung cancer. Of these, 77 received HB and 197 did not. Propensity score matching extracted 124 patients, consisting of 62 patients with HB and 62 patients without HB. Endpoints were surgical safety.

Results: There was no statistically significant difference in the outcomes of surgical safety outcomes between the HB and non-HB group after propensity-score matching, operative time (172 vs. 203 min, p = 0.131), volume of blood loss (60 vs. 70 ml, p = 0.335), need for intraoperative RBC transfusion (3.2 vs. 6.5%, p = 0.680), chest tube drainage volume on the 1st postoperative day (200 vs. 200 ml, p = 0.796), and chest tube placement duration (3 vs. 3 days, p = 0.606).

Conclusions: The influence of perioperative HB on postoperative thromboembolic or bleeding events in lung cancer surgery is not obvious, but its surgical safety appears to be acceptable.

Keywords: Anti-clotting drug; Heparin bridging; Lung cancer.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anticoagulants / therapeutic use*
  • Blood Loss, Surgical
  • Blood Transfusion
  • Blood Volume
  • Chest Tubes
  • Drainage
  • Female
  • Heparin / therapeutic use*
  • Humans
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • Operative Time
  • Perioperative Care
  • Propensity Score
  • Retrospective Studies
  • Time Factors

Substances

  • Anticoagulants
  • Heparin