PMID- 28544292
OWN - NLM
STAT- MEDLINE
DCOM- 20170612
LR  - 20190320
IS  - 1464-410X (Electronic)
IS  - 1464-4096 (Linking)
VI  - 119 Suppl 5
DP  - 2017 May
TI  - Perioperative adverse events in patients on continued anticoagulation undergoing 
      photoselective vaporisation of the prostate with the 180-W Greenlight lithium 
      triborate laser.
PG  - 33-38
LID - 10.1111/bju.13822 [doi]
AB  - OBJECTIVES: To compare perioperative factors and adverse events (AEs) in men 
      undergoing photoselective vaporisation of the prostate (PVP) with or without 
      continued anticoagulation therapy. PATIENTS AND METHODS: Retrospective review of 
      a PVP database of men treated with the 180-W lithium triborate (LBO) laser from 
      2010 to 2016. Of 373 men, 59 underwent PVP with continued anticoagulant therapy, 
      which was defined as treatment with heparin, warfarin, clopidogrel, dipyridamol 
      or new oral anticoagulant drugs. Perioperative factors and AEs occurring within 
      90 days of surgery were analysed. RESULTS: There was no statistically significant 
      difference in the overall incidence of perioperative AEs between those receiving 
      and not receiving anticoagulation therapy (30.5% vs 19.9%, P = 0.07). However, 
      there was a statistically significant difference in the incidence of high-grade 
      Clavien-Dindo events in men who continued anticoagulation during PVP (P = 0.01). 
      No men required blood transfusion. There was no difference in operative times and 
      energy utilisation between the groups. In all, 53 of the 59 men in the 
      anticoagulation group had a high-grade American Society of Anesthesiologists 
      score, compared to 27 of the 272 men in the control group. The anticoagulation 
      group were also significantly older. The anticoagulation group had a 
      significantly longer length of hospital stay and duration of catheterisation 
      compared to the controls. CONCLUSIONS: While continued anticoagulation therapy is 
      not associated with an overall increase in perioperative AEs, it is associated 
      with an increased rate of high-grade Clavien-Dindo events. The findings of this 
      study suggest that there should be caution in extrapolating results about the 
      safety profile of earlier generation lasers to the current 180-W LBO laser for 
      patients on anticoagulation.
CI  - (c) 2017 The Authors BJU International (c) 2017 BJU International Published by John 
      Wiley & Sons Ltd.
FAU - Knapp, Georgia L
AU  - Knapp GL
AD  - Deakin University, Burwood, Vic., Australia.
FAU - Chalasani, Venu
AU  - Chalasani V
AD  - Sydney Adventist Hospital Clinical School, University of Sydney, Wahroonga, NSW, 
      Australia.
FAU - Woo, Henry H
AU  - Woo HH
AD  - Sydney Adventist Hospital Clinical School, University of Sydney, Wahroonga, NSW, 
      Australia.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - England
TA  - BJU Int
JT  - BJU international
JID - 100886721
RN  - 0 (Anticoagulants)
RN  - 0 (Borates)
RN  - 0 (Lithium Compounds)
RN  - G5N01T5TYY (lithium borate)
SB  - IM
MH  - Aged
MH  - Anticoagulants/*therapeutic use
MH  - Borates
MH  - Humans
MH  - Laser Therapy/*adverse effects/methods
MH  - Lithium Compounds
MH  - Male
MH  - Postoperative Complications
MH  - Prostate/*pathology/surgery
MH  - Prostatectomy/*adverse effects/methods
MH  - Retrospective Studies
MH  - Transurethral Resection of Prostate/*methods
MH  - Treatment Outcome
OTO - NOTNLM
OT  - 180-W XPS Greenlight
OT  - anticoagulants
OT  - laser therapy
OT  - prostate
OT  - prostatectomy
OT  - prostatic hyperplasia
EDAT- 2017/05/26 06:00
MHDA- 2019/03/21 06:00
CRDT- 2017/05/26 06:00
PHST- 2017/05/26 06:00 [entrez]
PHST- 2017/05/26 06:00 [pubmed]
PHST- 2019/03/21 06:00 [medline]
AID - 10.1111/bju.13822 [doi]
PST - ppublish
SO  - BJU Int. 2017 May;119 Suppl 5:33-38. doi: 10.1111/bju.13822.