Title: Emergency gastrointestinal surgery in patients undergoing  antithrombotic therapy in a
single general hospital: A propensity  score-matched analysis
Version: 3 Date: 10 May 2021
Reviewer's report:
Thank you for the opportunity to review this manuscript entitled: " Emergency gastrointestinal
surgery in patients undergoing antithrombotic therapy in a single general hospital: A propensity
score-matched analysis” by Abe S et al.
The authors’ aim in this study is evaluate the risk of bleeding in patient on AT underwent
emergency surgical procedure
The authors conclude that intraoperative blood loss and postoperative complications related to
emergency gastrointestinal surgery were not significantly affected by antithrombotic therapy.
Major comments:
From several years and in different studies it is shown that it is not necessary to suspend the
therapy with antiplatelet drugs  such as acetylsalicylic acid before surgeries both in urgency and
in emergency setting
The problem arises in patients on anticoagulant therapy and not in prophylaxis for the risk of
thrombosis and especially in patients with bleeding at the time of access to the emergency room.
In fact, if the surgical procedure is quod vitam it is not necessary to consider the use of such
drugs, otherwise various protocols have been developed for the suspension and normalization
of coagulant funzinalite in patients needing a surgical intervention under deferred urgency.
I would have expected from the authors a differentiation of patients according to the type of
urgency and especially in the light of the results the development of a protocol or an algorithm
to be adopted according to the drugs taken by the patient.
Moreover, more then 50% of the procedure were appendectomy, therefore an intervention of
itself at low risk of bleeding.
No data among energy device used
how do the authors explain an average operating time of 36 and 53 minutes? in an emergency
setting with a range starting from 10 minutes?
Title: Emergency gastrointestinal surgery in patients undergoing  antithrombotic therapy in a
single general hospital: A propensity  score-matched analysis
Version: 3 Date: 10 May 2021
Reviewer's report:
Thank you for the opportunity to review this manuscript entitled: " Emergency gastrointestinal
surgery in patients undergoing antithrombotic therapy in a single general hospital: A propensity
score-matched analysis” by Abe S et al.
The authors’ aim in this study is evaluate the risk of bleeding in patient on AT underwent
emergency surgical procedure
The authors conclude that intraoperative blood loss and postoperative complications related to
emergency gastrointestinal surgery were not significantly affected by antithrombotic therapy.
Major comments:
From several years and in different studies it is shown that it is not necessary to suspend the
therapy with antiplatelet drugs  such as acetylsalicylic acid before surgeries both in urgency and
in emergency setting
The problem arises in patients on anticoagulant therapy and not in prophylaxis for the risk of
thrombosis and especially in patients with bleeding at the time of access to the emergency room.
In fact, if the surgical procedure is quod vitam it is not necessary to consider the use of such
drugs, otherwise various protocols have been developed for the suspension and normalization
of coagulant funzinalite in patients needing a surgical intervention under deferred urgency.
I would have expected from the authors a differentiation of patients according to the type of
urgency and especially in the light of the results the development of a protocol or an algorithm
to be adopted according to the drugs taken by the patient.
Moreover, more then 50% of the procedure were appendectomy, therefore an intervention of
itself at low risk of bleeding.
No data among energy device used
how do the authors explain an average operating time of 36 and 53 minutes? in an emergency
setting with a range starting from 10 minutes?
Please review this paper.
user
Title: Emergency gastrointestinal surgery in patients undergoing  antithrombotic therapy in a
single general hospital: A propensity  score-matched analysis
Version: 3 Date: 10 May 2021
Reviewer's report:
Thank you for the opportunity to review this manuscript entitled: " Emergency gastrointestinal
surgery in patients undergoing antithrombotic therapy in a single general hospital: A propensity
score-matched analysis” by Abe S et al.
The authors’ aim in this study is evaluate the risk of bleeding in patient on AT underwent
emergency surgical procedure
The authors conclude that intraoperative blood loss and postoperative complications related to
emergency gastrointestinal surgery were not significantly affected by antithrombotic therapy.
Major comments:
From several years and in different studies it is shown that it is not necessary to suspend the
therapy with antiplatelet drugs  such as acetylsalicylic acid before surgeries both in urgency and
in emergency setting
The problem arises in patients on anticoagulant therapy and not in prophylaxis for the risk of
thrombosis and especially in patients with bleeding at the time of access to the emergency room.
In fact, if the surgical procedure is quod vitam it is not necessary to consider the use of such
drugs, otherwise various protocols have been developed for the suspension and normalization
of coagulant funzinalite in patients needing a surgical intervention under deferred urgency.
I would have expected from the authors a differentiation of patients according to the type of
urgency and especially in the light of the results the development of a protocol or an algorithm
to be adopted according to the drugs taken by the patient.
Moreover, more then 50% of the procedure were appendectomy, therefore an intervention of
itself at low risk of bleeding.
No data among energy device used
how do the authors explain an average operating time of 36 and 53 minutes? in an emergency
setting with a range starting from 10 minutes?
assistant