PMID- 29037064
OWN - NLM
STAT- MEDLINE
DCOM- 20180703
LR  - 20181202
IS  - 1557-900X (Electronic)
IS  - 0892-7790 (Linking)
VI  - 31
IP  - 12
DP  - 2017 Dec
TI  - Outcome of Transurethral Resection of Bladder Tumor: Does Antiplatelet Therapy 
      Really Matter? Analysis of a Retrospective Series.
PG  - 1284-1288
LID - 10.1089/end.2017.0587 [doi]
AB  - INTRODUCTION: Transurethral resection of bladder tumor (TURBT) is considered to 
      be at a moderate or high risk of bleeding during surgical procedure. The number 
      of patients on antiplatelet (AP) drugs has been increasing; we wanted to assess 
      their impact on the outcome of patients undergoing scheduled TURBT. MATERIALS AND 
      METHODS: A retrospective assessment of noninferiority of 450 consecutive 
      procedures performed between April 2013 and June 2015 was conducted. Patients 
      were divided in two groups: naive or AP drug users. The primary endpoint was the 
      average length of stay (ALOS). Noninferiority was set at 1 day. A subgroup 
      analysis comparing the acetylsalicylic acid (ASA) group and clopidogrel group to 
      the naive group was performed. Multivariate analysis was performed to find the 
      determinants of a longer ALOS. Chi-square or Fisher tests were used to analyze 
      categorical variables, and Student's or Mann-Whitney tests were used to analyze 
      quantitative variables. RESULTS: We included 325 patients who underwent TURBT: 
      117 received AP drugs (ASA, 85; clopidogrel, 32) and 208 were naive to AP drugs 
      (of whom 117 were consecutively analyzed). The ALOSs were 2.5 days (naive group) 
      and 2.9 days (AP group). The subgroup analysis showed ALOSs of 2.6 days (ASA 
      group) and 3.7 days (clopidogrel group). Clopidogrel therapy (odds ratio = 4.1 
      [1.7-9.6]) and the duration and depth of resection emerged as determinants of a 
      longer ALOS in multivariate analysis. Perioperative management of AP therapies 
      was achieved according to recommended practices. CONCLUSIONS: The ALOS of 
      patients receiving AP drugs was not clinically different from naive patients. 
      This result was identical for patients receiving ASA. However, clopidogrel 
      increased the length of stay, making us question its use in perioperative 
      management.
FAU - Prader, Romain
AU  - Prader R
AD  - 1 Department of Urology and Transplantation, University Hospital of Nice , Nice, 
      France .
FAU - De Broca, Bruno
AU  - De Broca B
AD  - 2 Department of Anesthesia, University Hospital of Amiens, Salouel, France .
FAU - Chevallier, Daniel
AU  - Chevallier D
AD  - 1 Department of Urology and Transplantation, University Hospital of Nice , Nice, 
      France .
FAU - Amiel, Jean
AU  - Amiel J
AD  - 1 Department of Urology and Transplantation, University Hospital of Nice , Nice, 
      France .
FAU - Durand, Matthieu
AU  - Durand M
AD  - 1 Department of Urology and Transplantation, University Hospital of Nice , Nice, 
      France .
LA  - eng
PT  - Journal Article
DEP - 20171207
PL  - United States
TA  - J Endourol
JT  - Journal of endourology
JID - 8807503
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - A74586SNO7 (Clopidogrel)
RN  - OM90ZUW7M1 (Ticlopidine)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
CIN - Transl Androl Urol. 2018 May;7(Suppl 2):S236-S237. PMID: 29928621
CIN - Transl Androl Urol. 2018 May;7(Suppl 2):S246-S247. PMID: 29928625
CIN - Transl Androl Urol. 2018 May;7(Suppl 2):S258-S259. PMID: 29928629
MH  - Aged
MH  - Aged, 80 and over
MH  - Aspirin/*therapeutic use
MH  - Blood Loss, Surgical/*statistics & numerical data
MH  - Carcinoma, Transitional Cell/*surgery
MH  - Clopidogrel
MH  - Cystoscopy/*methods
MH  - Female
MH  - Hemorrhage/epidemiology
MH  - Humans
MH  - Intraoperative Complications/epidemiology
MH  - Length of Stay/*statistics & numerical data
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Odds Ratio
MH  - Platelet Aggregation Inhibitors/*therapeutic use
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Ticlopidine/*analogs & derivatives/therapeutic use
MH  - Urinary Bladder Neoplasms/*surgery
MH  - Urologic Surgical Procedures
OTO - NOTNLM
OT  - TURBT
OT  - antiaggregant
OT  - antiplatelet
OT  - aspirin
OT  - bladder cancer
EDAT- 2017/10/19 06:00
MHDA- 2018/07/04 06:00
CRDT- 2017/10/18 06:00
PHST- 2017/10/19 06:00 [pubmed]
PHST- 2018/07/04 06:00 [medline]
PHST- 2017/10/18 06:00 [entrez]
AID - 10.1089/end.2017.0587 [doi]
PST - ppublish
SO  - J Endourol. 2017 Dec;31(12):1284-1288. doi: 10.1089/end.2017.0587. Epub 2017 Dec 
      7.