Radical Prostatectomy With Robot-assisted Radical Prostatectomy and Laparoscopic Radical Prostatectomy Under Low-dose Aspirin Does Not Significantly Increase Blood Loss

被引:21
作者
Binhas, Michele [1 ]
Salomon, Laurent
Roudot-Thoraval, Francoise
Armand, Catherine
Plaud, Benoit
Marty, Jean
机构
[1] Henri Mondor Albert Chenevier Univ Hosp, AP HP, Dept Anaesthesiol & Intens Care, F-94010 Creteil, France
关键词
POSTPROSTATECTOMY HEMORRHAGE; TRANSURETHRAL PROSTATECTOMY; CARDIOVASCULAR EVENTS; PRIMARY PREVENTION; STENT THROMBOSIS; METAANALYSIS; PREDICTORS; MANAGEMENT; WITHDRAWAL; THERAPY;
D O I
10.1016/j.urology.2011.11.031
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE To determine whether maintaining use of low-dose aspirin confers a higher risk of bleeding events in patients undergoing laparoscopic or robot-assisted radical prostatectomy. There is no consensus on maintaining or withdrawing aspirin in these patients. METHODS Consecutive patients undergoing laparoscopic and robot-assisted radical prostatectomy between January 2009 and December 2010 were included in a prospective cohort study. Among them, 54 aspirin-treated patients were compared with 569 non-aspirin-treated patients. We evaluated the between-group difference in bleeding event: intraoperative blood loss >= 700 ml and/or need for transfusion and/or postoperative hemorrhagic complication (symptomatic abdominal wall hematomas, major bleeding requiring reoperation). Differences in each component of the bleeding event, in hemoglobin level changes, and hospital stay length were also evaluated. Patients' data were compared using the chi(2) or Fisher exact test for categorical variables and the Student t test or Mann-Whitney test for continuous variables. RESULTS A bleeding event occurred in 18 (33.3%) aspirin-treated patients and 176 (32.5%) non-aspirin-treated patients (P = .66). Median blood loss was similar in the 2 groups (aspirin: 450 ml, 50-7100 ml; no aspirin: 450 ml, 100-2800 ml; P = .93). Aspirin was not associated with a significant hemoglobin level variation (median decrease, 2.9 g/dL with aspirin and 3.2 g/dL without aspirin, P = .23). Median hospital length of stay, rates of blood transfusion, and postoperative hemorrhagic complications were similar in the 2 groups. CONCLUSION Laparoscopic and robot-assisted radical prostatectomy can be performed safely without discontinuing aspirin, as this policy does not increase significantly blood loss, blood transfusion requirements, postoperative hemorrhagic complications. or hospital length of stay. UROLOGY 79: 591-595, 2012. (C) 2012 Elsevier Inc.
引用
收藏
页码:591 / 595
页数:5
相关论文
共 28 条
[11]  
Hakimi Ari Abraham, 2007, Urol J, V4, P130
[12]   Transrectal ultrasound-guided biopsy of the prostate: aspirin increases the incidence of minor bleeding complications [J].
Halliwell, O. T. ;
Yadegafar, G. ;
Lane, C. ;
Dewbury, K. C. .
CLINICAL RADIOLOGY, 2008, 63 (05) :557-561
[13]   Influence of body weight and prostate volume on intraoperative, perioperative, and postoperative outcomes after radical retropubic prostatectomy [J].
Hsu, EI ;
Hong, EK ;
Lepor, H .
UROLOGY, 2003, 61 (03) :601-606
[14]   Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents [J].
Iakovou, I ;
Schmidt, T ;
Bonizzoni, E ;
Ge, L ;
Sangiorgi, GM ;
Stankovic, G ;
Airoldi, F ;
Chieffo, A ;
Montorfano, M ;
Carlino, M ;
Michev, I ;
Corvaja, N ;
Briguori, C ;
Gerckens, U ;
Grube, E ;
Colombo, A .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2005, 293 (17) :2126-2130
[15]   Preoperative predictors of blood loss at the time of radical prostatectomy: results from the SEARCH database [J].
Lloyd, J. C. ;
Banez, L. L. ;
Aronson, W. J. ;
Terris, M. K. ;
Presti, J. C., Jr. ;
Amling, C. L. ;
Kane, C. J. ;
Freedland, S. J. .
PROSTATE CANCER AND PROSTATIC DISEASES, 2009, 12 (03) :264-268
[16]   Late thrombosis in drug-eluting coronary stents after discontinuation of antiplatelet therapy [J].
McFadden, EP ;
Stabile, E ;
Regar, E ;
Cheneau, E ;
Ong, ATL ;
Kinnaird, T ;
Suddath, WO ;
Weissman, NJ ;
Torguson, R ;
Kent, KM ;
Pichard, AD ;
Satler, LF ;
Waksman, R ;
Serruys, PW .
LANCET, 2004, 364 (9444) :1519-1521
[17]   The effect of low-dose acetylsalicylic acid on bleeding after transurethral prostatectomy - A prospective, randomized, double-blind, placebo-controlled study [J].
Nielsen, JD ;
Holm-Nielsen, A ;
Jespersen, J ;
Vinther, CC ;
Settgast, IW ;
Gram, J .
SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY, 2000, 34 (03) :194-198
[18]   To continue or discontinue aspirin in the perioperative period: a randomized, controlled clinical trial [J].
Oscarsson, A. ;
Gupta, A. ;
Fredrikson, M. ;
Jarhult, J. ;
Nystrom, M. ;
Pettersson, E. ;
Darvish, B. ;
Krook, H. ;
Swahn, E. ;
Eintrei, C. .
BRITISH JOURNAL OF ANAESTHESIA, 2010, 104 (03) :305-312
[19]   Oncologic Outcome after Extraperitoneal Laparoscopic Radical Prostatectomy: Midterm Follow-up of 1115 Procedures [J].
Paul, Alexandre ;
Ploussard, Guillaume ;
Nicolaiew, Nathalie ;
Xylinas, Evanguelos ;
Gillion, Norman ;
de la Taille, Alexandre ;
Vordos, Dimitri ;
Hoznek, Andras ;
Yiou, Rene ;
Abbou, Claude Clement ;
Salomon, Laurent .
EUROPEAN UROLOGY, 2010, 57 (02) :267-272
[20]  
Ploussard G, 2009, BJU INT, V105, P1155