Thoracoscopic surgery for lung cancer without interruption of anti-platelet agents: is it really safe?

Recently, thoracoscopic surgery has expanded globally as a minimally invasive alternative for thoracotomy because of its low invasiveness and painless aspect and the extremely good self-reported quality of life following this surgery (1). Elderly patients with several complications who have been diagnosed with lung cancer are highly appropriate candidates for thoracoscopic resection (2). In this regard, a number of operative cases present with several underlying diseases, ischemic heart disease, cerebral infarction and several autoimmune diseases. When those patients undergo an operation, they should be checked for prescribed drugs, and anti-platelet agents (APAs) should be discontinued in order to prevent complications such as bleeding associated with anesthetic and perioperative treatments. Simultaneously, surgeons must also be alert for thrombus due to the interruption of these APAs during the perioperative period.