Radical cystectomy under continuous antiplatelet therapy with acetylsalicylic acid.
Eur J Surg Oncol
; 45(7): 1260-1265, 2019 Jul.
Article
in En
| MEDLINE
| ID: mdl-30827801
ABSTRACT
INTRODUCTION:
Aim of this study was to analyse the perioperative outcome of patients undergoing radical cystectomy under continuous antiplatelet therapy with acetylsalicylic acid. MATERIALS ANDMETHODS:
Using prospectively maintained databases of two departments of urology, we identified 461 consecutive patients who underwent radical cystectomy for bladder cancer (2011-2017). Patients were divided into three groups 1) on-going antiplatelet therapy with acetylsalicylic acid (nâ¯=â¯50), 2) discontinuing antiplatelet therapy (nâ¯=â¯65) and 3) no antiplatelet therapy (nâ¯=â¯346). Perioperative outcome was compared between the three groups using ANOVA, likelihood ratio or Kruskal Wallis test with post-hoc testing. Uni- and multivariate analyses were performed to identify predictor for perioperative complications and transfusion.RESULTS:
Group 1 showed an average estimated blood loss of 732⯱â¯424, group 2 752⯱â¯488 and group 3 810⯱â¯544â¯ml (pâ¯=â¯0.51). There was no significant difference in transfusion rate (44% in group 1, 45% and 39% in groups 2 and 3, pâ¯=â¯0.63). Severe complications occurred in 26%, 15% and 15% in groups 1-3 (pâ¯=â¯0.19). Ischemic complications were more often observed in group 1 (nâ¯=â¯4, 8%) and 2 (nâ¯=â¯5, 8%) than group 3 (nâ¯=â¯7, 2%), pâ¯=â¯0.02. 90-day readmission (nâ¯=â¯99, 22%) and mortality rate (nâ¯=â¯10, 2.2%) were low and did not show any significant differences between the groups. In uni- and multivariate analysis ongoing therapy with acetylsalicylic acid was no independent risk factor for transfusion or severe complications.CONCLUSION:
Perioperative continuation of therapy with acetylsalicylic acid in radical cystectomy is safe with no difference in intraoperative blood loss, transfusion rate, complications or mortality.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Postoperative Complications
/
Urinary Diversion
/
Urinary Bladder Neoplasms
/
Platelet Aggregation Inhibitors
/
Cystectomy
/
Aspirin
/
Deprescriptions
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Eur J Surg Oncol
Journal subject:
NEOPLASIAS
Year:
2019
Document type:
Article