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Aspirin and clopidogrel during robotic partial nephrectomy, is it safe?
Department of Surgery, Division of Urology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
Address correspondence to Dr.AndrewA. Wagner, Dept of Surgery, Division of Urology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA02215 USA
Canadian Journal of Urology 2015, 22(5), 7984-7989.
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Introduction: Continuation of antiplatelet medications through major urologic surgery may increase the risk of intraoperative and postoperative bleeding complications. However, withdrawal of antiplatelet therapy may place some patients at high risk of serious cardiovascular or cerebrovascular complications. We assess the feasibility of performing robotic partial nephrectomy (RPN) in patients maintained on aspirin or dual antiplatelet therapy with aspirin and clopidogrel.Material and methods: Perioperative data was collected prospectively on 230 subjects undergoing RPN enrolled in an IRB approved quality of life study. We analyzed subjects who were maintained on either aspirin alone or both aspirin and clopidogrel throughout the operative and perioperative period.
Results: Of the 230 patients, six were identified who continued antiplatelet medication throughout the perioperative period. Four patients were maintained on 81 mg of aspirin and two patients continued aspirin and clopidogrel. Average RENAL score was 7 with mean tumor size of 4.1 cm. There were no intraoperative complications and no conversions to open surgery. Average estimated blood loss was 242 mL. Ninety day complication rate was 33%. One patient had postoperative bleeding on day 14 after restarting coumadin in addition to their aspirin.
Conclusions: We present a case series demonstrating that in carefully selected patients, RPN on aspirin and clopidogrel is feasible and safe. This is the first report of patients who underwent RPN while on both aspirin and clopidogrel.
Keywords
aspirin, clopidogrel, robotic surgery, nephrectomy
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APA Style
Althaus, A.B., Dovirak, O., Chang, P., Taylor, K.N., O’Halloran, T.D. et al. (2015). Aspirin and clopidogrel during robotic partial nephrectomy, is it safe?. Canadian Journal of Urology, 22(5), 7984–7989.
Vancouver Style
Althaus AB, Dovirak O, Chang P, Taylor KN, O’Halloran TD, Wagner AA. Aspirin and clopidogrel during robotic partial nephrectomy, is it safe?. Can J Urology. 2015;22(5):7984–7989.
IEEE Style
A.B. Althaus, O. Dovirak, P. Chang, K.N. Taylor, T.D. O’Halloran, and A.A. Wagner, “Aspirin and clopidogrel during robotic partial nephrectomy, is it safe?,” Can. J. Urology, vol. 22, no. 5, pp. 7984–7989, 2015.
Copyright © 2015 The Author(s). Published by Tech Science Press.This work is licensed under a Creative Commons Attribution 4.0 International License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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