Risks and complications of robot-assisted radical prostatectomy (RARP) in patients receiving antiplatelet and/or anticoa
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ORIGINAL ARTICLE
Risks and complications of robot‑assisted radical prostatectomy (RARP) in patients receiving antiplatelet and/or anticoagulant therapy: a retrospective cohort study in a single institute Masashi Oshima1 · Satoshi Washino1 · Yuhki Nakamura1 · Tsuzumi Konishi1 · Kimitoshi Saito1 · Yoshiaki Arai1 · Tomoaki Miyagawa1 Received: 31 August 2020 / Accepted: 25 September 2020 © The Author(s) 2020
Abstract The objective of the study was to evaluate the risk of bleeding complications in patients undergoing robot-assisted radical prostatectomy (RARP) while taking antiplatelet (AP) and/or anticoagulant (AC) agents. We analyzed the data of 334 patients undergoing RARP from May 2015 to May 2019. Patients were categorized into AP, AC, and control groups; the bleeding complications were compared among them. The end points were the estimated blood loss, decrease in hemoglobin level, and bleeding complications. The patient characteristics did not differ significantly among groups, with the exception of ASA scores, which were significantly higher in the AP and AC groups vs. the control group. The estimated blood loss and hemoglobin decrease were not significantly different between the AP and AC groups and the control group. The frequency of bleeding complications did not differ significantly between the AP and the control groups, but was significantly higher in the AC vs. the control group (4.3% in the AP and 23.5% in the AC group vs. 3.7% in the control group; P = 0.63 and P 0.99
0.32
0.29
0.28
0.26
0.33
A vs. C2
> 0.99
0.06
0.08
0.31
0.78
0.87
A vs. C
> 0.99
0.54
0.73
0.74
0.18
0.23
C1 vs. C2
Journal of Robotic Surgery
B1
114.7 ± 38.6
A
124.8 ± 100.3
6 (6, 7)
Median (IQR)
Blood transfu- 0 (0%) sion after surgery, n (%)
3 (1.1%)
7 (2.6%)
Gd1
Gd2
0 (0%)
0 (0%) 2 (4.3%)
2 (5.1%)
0 (0%)
Gd4. 5
0 (0%)
0 (0%)
2 (28.6%)
1 (14.3%)
4 (57.1%)
0 (0%)
0 (0%)
6 (15.4%)
5 (12.8%)
28 (71.8%)
0 (0%)
0 (0%)
8 (17.4%)
6 (13.0%)
0 (0%)
0 (0%)
0 (0%)
3 (42.9%)
4 (57.1%)
0 (0%)
2 (28.6%)
5 (71.4%)
0 (0%)
7 (7, 7)
6.9 ± 0.3
6 (6, 6)
11.7 ± 14.0
89.0 ± 39.3
C1
Interruption (n = 7)
AC group
0 (0%)
0 (0%)
2 (20.0%)
3 (30.0%)
5 (50.0%)
1 (10.0%)
1 (10.0%)
8 (80.0%)
0 (0%)
9 (8, 12)
9.9 ± 2.7
8 (6, 19)
12.9 ± 9.1
127.3 ± 153.5
C2
Heparinization (n = 10)
*Complications according to Clavien–Dindo classification
AP antiplatelet, AC anticoagulant, POD postoperative day, Gd grade, NA not assessed
39 (14.8%)
5 (1.8%)
Gd2
35 (12.9%)
Gd1
Gd3
191 (70.5%)
Gd0
32 (69.6%)
0 (0%)
44 (95.7%)
0 (0%)
7 (7, 7)
7.6 ± 2.1
6 (6, 6)
9.4 ± 9.2
140.6 ± 89.9
B
Total (n = 46)
0 (0%)
37 (94.9%)
0 (0%)
7 (7, 7)
7.6 ± 2.2
6 (6, 6)
9.3 ± 8.8
145.6 ± 95.5
B2
Continuing (n = 39)
Complications* during 90 days after surgery, n (%)
260 (96.3%)
Gd0
7 (100%)
0 (0%)
7 (7, 8)
Bleeding complications*, n (%)
7 (6, 9)
7.5 ± 1.6
Median (IQR)
7.3 ± 1.2
6 (5, 6)
Mean ± SD
Hospitalization (days)
9.0 ± 9.5
Mean ± SD
10.3 ± 11.3
Interrup
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