@Article{,
AUTHOR = {Muqsit Buchh, Courtney Yong, Fezaan Kazi, Ali Sualeh, James Slaven, Ronald S. Boris, Chandru P. Sundaram},
TITLE = {Preoperative aspirin and anticoagulants do not affect partial nephrectomy bleeding},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {31},
YEAR = {2024},
NUMBER = {2},
PAGES = {11834--11839},
URL = {http://www.techscience.com/CJU/v31n2/59597},
ISSN = {1488-5581},
ABSTRACT = {<b>Introduction:</b> Studies have reached mixed conclusions
on the role of antiplatelet and anticoagulant agents on
postoperative complications of partial nephrectomies. This
study examines whether preoperative anticoagulation
use affected the risk of hemorrhagic complications after
partial nephrectomy.<br/>
<b>Materials and methods:</b> This is a retrospective chart
review of all partial nephrectomies performed between
2017 and 2022 at a single institution. For each
operation, preoperative data was gathered on whether
the patient was on anticoagulation, the type and dose of
anticoagulation, and how many days the anticoagulation
was held preoperatively. Bivariate analyses for continuous
measures were performed using Student’s t-tests when
there were two comparison groups and ANOVA models
when there were more than two comparison groups and
Chi-Square tests were used for categorical variables, with
Fisher’s Exact being used when expected cell counts were
small.<br/>
<b>Results:</b> In this study, warfarin was held for an average
of 5.43 days, clopidogrel was held for an average of 6.60
days, aspirin was held for an average of 7.65 days, and direct oral anticoagulants (DOACs) were held for an
average of 4.00 days. There was no significant difference
in hemoglobin (Hb) change, rate of intraoperative
transfusion, postoperative transfusion, bleeding
complication, pseudoaneurysm rate, or additional bleeding
processes between patients on prior anticoagulation
therapy and those not on therapy. There was no significant
difference in intraoperative or postoperative outcomes
based on history of aspirin use and continuation of
aspirin through the surgery. While estimated blood loss
appeared statistically significant initially, this difference
was accounted for by the covariates of comorbidities,
RENAL score, surgical approach, and type of renorrhaphy.
Overall, there was no difference in complication rate based
solely on aspirin use or continuation of aspirin through
surgery.<br/>
<b>Conclusions:</b> No difference in complication rate of partial
nephrectomy was determined to be solely due to prior use
of anticoagulation or aspirin use alone with appropriate
cessation of anticoagulation preoperatively. Overall,
patients on anticoagulation are not at a higher risk of
intraoperative or postoperative bleeding complications
when undergoing partial nephrectomy.},
DOI = {}
}