Abstract
Antiplatelet drugs are used to treat and prevent arterial thromboses such as cerebral infarction, myocardial infarction, and peripheral arterial thrombosis. There are no clear criteria for determining whether the administration of antiplatelet agents should be continued at the time of surgery in view of the onset of thrombosis/embolism or discontinued due to the risk of major bleeding. In this article, we report on our clinical examination of the safety of neck dissections under the continuous administration of antiplatelet drugs.
The study included 23 subjects who met the criteria from among those who underwent surgery for primary oral cancer, experienced subsequent metastases to the cervical lymph nodes, and underwent unilateral total neck dissections alone at our department from July 2010 to December 2020. We divided the subjects into a group which orally ingested antiplatelet drugs and a group without oral administration of the same drugs and compared them retrospectively. There were 6 cases in the oral administration group and 17 cases in the group without oral administration. Intraoperative bleeding, postoperative drainage, postoperative Hb, and rate of change in RBC did not differ significantly between the two groups. No onset of postoperative bleeding, postoperative hemorrhagic complications, or thromboembolic complications were observed in either group.
This study demonstrated that neck dissections can be performed under the continuous administration of antiplatelet drugs. However, postoperative bleeding following neck dissections may be life-threatening due to airway obstruction. If antiplatelet drugs are continued, careful intraoperative hemostasis and strict postoperative management are vital. Due to the small sample size of this study, we believe a multicenter accumulation of subjects is needed for further examinations.
