PMID- 27669654
OWN - NLM
STAT- MEDLINE
DCOM- 20180314
LR  - 20181202
IS  - 1527-9995 (Electronic)
IS  - 0090-4295 (Linking)
VI  - 99
DP  - 2017 Jan
TI  - Impact of Anticoagulant and Antiplatelet Drugs on Perioperative Outcomes of 
      Robotic-assisted Partial Nephrectomy.
PG  - 118-122
LID - S0090-4295(16)30606-9 [pii]
LID - 10.1016/j.urology.2016.09.009 [doi]
AB  - OBJECTIVE: To evaluate the impact of anticoagulant (AC) or antiplatelet (AP) 
      therapy on the morbidity of robot-assisted partial nephrectomy (RAPN). MATERIALS 
      AND METHODS: From 2011 to 2015, we retrospectively analyzed a prospectively 
      maintained institutional review board-approved database of RAPN from 2 academic 
      departments of urology. We evaluated the occurrence of overall complications and 
      hemorrhagic complications (pseudoaneurysm, arteriovenous fistula, hematoma, 
      transfusion). Patients with therapeutic AC or AP, stopped or not before surgery, 
      were compared with patients without therapeutic AC or AP. A logistic regression 
      model was used to identify predictors of complications. RESULTS: Out of 533 
      patients who underwent RAPN, 70 had AC or AP (50% aspirin, 25% clopidogrel, 28% 
      AC, 8% direct oral AC). Clopidogrel, AC, and direct oral AC were always stopped 
      preoperatively. Aspirin was continued in 25% of the cases. In univariate 
      analysis, overall complications (39.2% vs 17.4%; P = .001) and hemorrhagic 
      complications (32.7% vs 9.6%; P <.001) were higher in patients on AC or AP. 
      Hospital stay was longer in the group with therapeutic AC or AP treatment (5.1 vs 
      3.9 days; P <.001). In multivariate analysis, predictors of complications were 
      intake of therapeutic AC (odds ratio [OR] = 4.3, IC95% [1.2-15.9], P = .03) and 
      tumor size (OR = 1.8, IC95% [1.3-7.2], P = .03). Patients on aspirin tended to 
      have more complications (OR = 2.4; IC95% [0.4-9.3]; P = .15). CONCLUSION: AP and 
      therapeutic AC increase the morbidity of RAPN. These treatments should be taken 
      into account in treatment decision-making algorithm of small renal masses.
CI  - Copyright (c) 2016 Elsevier Inc. All rights reserved.
FAU - Pradere, Benjamin
AU  - Pradere B
AD  - Service d'Urologie, CHU Rennes, Rennes, France. Electronic address: 
      benjaminpradere@gmail.com.
FAU - Peyronnet, Benoit
AU  - Peyronnet B
AD  - Service d'Urologie, CHU Rennes, Rennes, France.
FAU - Seisen, Thomas
AU  - Seisen T
AD  - Service d'Urologie, Hopital Pitie-Salpetriere, Paris, France.
FAU - Khene, Zineddine
AU  - Khene Z
AD  - Service d'Urologie, CHU Rennes, Rennes, France.
FAU - Ruggiero, Marina
AU  - Ruggiero M
AD  - Service d'Urologie, Hopital Pitie-Salpetriere, Paris, France.
FAU - Vaessen, Christophe
AU  - Vaessen C
AD  - Service d'Urologie, Hopital Pitie-Salpetriere, Paris, France.
FAU - Verhoest, Gregory
AU  - Verhoest G
AD  - Service d'Urologie, CHU Rennes, Rennes, France.
FAU - Mathieu, Romain
AU  - Mathieu R
AD  - Service d'Urologie, CHU Rennes, Rennes, France.
FAU - Roupret, Morgan
AU  - Roupret M
AD  - Service d'Urologie, Hopital Pitie-Salpetriere, Paris, France.
FAU - Bensalah, Karim
AU  - Bensalah K
AD  - Service d'Urologie, CHU Rennes, Rennes, France.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20160923
PL  - United States
TA  - Urology
JT  - Urology
JID - 0366151
RN  - 0 (Anticoagulants)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - A74586SNO7 (Clopidogrel)
RN  - OM90ZUW7M1 (Ticlopidine)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
CIN - J Urol. 2017 Jul;198(1):37-38. PMID: 28618708
MH  - Administration, Oral
MH  - Aged
MH  - Anticoagulants/*administration & dosage
MH  - Aspirin/*administration & dosage
MH  - Clopidogrel
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Kidney Neoplasms/*surgery
MH  - Male
MH  - Middle Aged
MH  - Morbidity/trends
MH  - Nephrectomy
MH  - Perioperative Care/*methods
MH  - Platelet Aggregation Inhibitors/administration & dosage
MH  - Postoperative Complications/*epidemiology/prevention & control
MH  - Retrospective Studies
MH  - Robotic Surgical Procedures
MH  - Ticlopidine/administration & dosage/*analogs & derivatives
EDAT- 2016/09/28 06:00
MHDA- 2018/03/15 06:00
CRDT- 2016/09/28 06:00
PHST- 2016/05/09 00:00 [received]
PHST- 2016/08/06 00:00 [revised]
PHST- 2016/09/07 00:00 [accepted]
PHST- 2016/09/28 06:00 [pubmed]
PHST- 2018/03/15 06:00 [medline]
PHST- 2016/09/28 06:00 [entrez]
AID - S0090-4295(16)30606-9 [pii]
AID - 10.1016/j.urology.2016.09.009 [doi]
PST - ppublish
SO  - Urology. 2017 Jan;99:118-122. doi: 10.1016/j.urology.2016.09.009. Epub 2016 Sep 
      23.