PMID- 33044699
OWN - NLM
STAT- MEDLINE
DCOM- 20211028
LR  - 20211028
IS  - 1863-2491 (Electronic)
IS  - 1863-2483 (Print)
IS  - 1863-2483 (Linking)
VI  - 15
IP  - 4
DP  - 2021 Aug
TI  - Risks and complications of robot-assisted radical prostatectomy (RARP) in 
      patients receiving antiplatelet and/or anticoagulant therapy: a retrospective 
      cohort study in a single institute.
PG  - 661-670
LID - 10.1007/s11701-020-01154-8 [doi]
AB  - The objective of the study was to evaluate the risk of bleeding complications in 
      patients undergoing robot-assisted radical prostatectomy (RARP) while taking 
      antiplatelet (AP) and/or anticoagulant (AC) agents. We analyzed the data of 334 
      patients undergoing RARP from May 2015 to May 2019. Patients were categorized 
      into AP, AC, and control groups; the bleeding complications were compared among 
      them. The end points were the estimated blood loss, decrease in hemoglobin level, 
      and bleeding complications. The patient characteristics did not differ 
      significantly among groups, with the exception of ASA scores, which were 
      significantly higher in the AP and AC groups vs. the control group. The estimated 
      blood loss and hemoglobin decrease were not significantly different between the 
      AP and AC groups and the control group. The frequency of bleeding complications 
      did not differ significantly between the AP and the control groups, but was 
      significantly higher in the AC vs. the control group (4.3% in the AP and 23.5% in 
      the AC group vs. 3.7% in the control group; P = 0.63 and P < 0.01, respectively). 
      There was no significant difference in bleeding complications between the AP 
      continuation (continuation of a single AP) and the AP interruption group or 
      between the heparin bridging and the AC interruption group. All bleeding 
      complications observed in the AC group occurred after resuming AC therapy. RARP 
      can be performed safely with continuation of a single AP, and in patients taking 
      ACs by interrupting these agents or via heparin bridging, without increasing 
      intraoperative bleeding, whereas postoperative bleeding complications may 
      increase after resuming ACs.
CI  - (c) 2020. The Author(s).
FAU - Oshima, Masashi
AU  - Oshima M
AUID- ORCID: 0000-0002-7365-1491
AD  - Department of Urology, Jichi Medical University Saitama Medical Center, 1-847, 
      Amanuma-cho, Saitama-shi, Saitama, 330-8503, Japan. m_ohshima@jichi.ac.jp.
FAU - Washino, Satoshi
AU  - Washino S
AD  - Department of Urology, Jichi Medical University Saitama Medical Center, 1-847, 
      Amanuma-cho, Saitama-shi, Saitama, 330-8503, Japan.
FAU - Nakamura, Yuhki
AU  - Nakamura Y
AD  - Department of Urology, Jichi Medical University Saitama Medical Center, 1-847, 
      Amanuma-cho, Saitama-shi, Saitama, 330-8503, Japan.
FAU - Konishi, Tsuzumi
AU  - Konishi T
AD  - Department of Urology, Jichi Medical University Saitama Medical Center, 1-847, 
      Amanuma-cho, Saitama-shi, Saitama, 330-8503, Japan.
FAU - Saito, Kimitoshi
AU  - Saito K
AD  - Department of Urology, Jichi Medical University Saitama Medical Center, 1-847, 
      Amanuma-cho, Saitama-shi, Saitama, 330-8503, Japan.
FAU - Arai, Yoshiaki
AU  - Arai Y
AD  - Department of Urology, Jichi Medical University Saitama Medical Center, 1-847, 
      Amanuma-cho, Saitama-shi, Saitama, 330-8503, Japan.
FAU - Miyagawa, Tomoaki
AU  - Miyagawa T
AD  - Department of Urology, Jichi Medical University Saitama Medical Center, 1-847, 
      Amanuma-cho, Saitama-shi, Saitama, 330-8503, Japan.
LA  - eng
PT  - Journal Article
DEP - 20201012
PL  - England
TA  - J Robot Surg
JT  - Journal of robotic surgery
JID - 101300401
RN  - 0 (Anticoagulants)
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Anticoagulants/adverse effects
MH  - Humans
MH  - Male
MH  - Platelet Aggregation Inhibitors/adverse effects
MH  - Postoperative Complications
MH  - Postoperative Hemorrhage/chemically induced/epidemiology
MH  - Prostatectomy/adverse effects
MH  - *Prostatic Neoplasms/surgery
MH  - Retrospective Studies
MH  - *Robotic Surgical Procedures/methods
MH  - *Robotics
MH  - Treatment Outcome
PMC - PMC8295093
OTO - NOTNLM
OT  - Anticoagulant
OT  - Antiplatelet
OT  - Complication
OT  - Heparin
OT  - Prostatectomy
COIS- Masashi Oshima, Satoshi Washino, Yuhki Nakamura, Tsuzumi Konishi, Kimitoshi 
      Saito, Yoshiaki Arai and Tomoaki Miyagawa declare that they have no conflict of 
      interest.
EDAT- 2020/10/13 06:00
MHDA- 2021/10/29 06:00
PMCR- 2020/10/12
CRDT- 2020/10/12 12:13
PHST- 2020/08/31 00:00 [received]
PHST- 2020/09/25 00:00 [accepted]
PHST- 2020/10/13 06:00 [pubmed]
PHST- 2021/10/29 06:00 [medline]
PHST- 2020/10/12 12:13 [entrez]
PHST- 2020/10/12 00:00 [pmc-release]
AID - 10.1007/s11701-020-01154-8 [pii]
AID - 1154 [pii]
AID - 10.1007/s11701-020-01154-8 [doi]
PST - ppublish
SO  - J Robot Surg. 2021 Aug;15(4):661-670. doi: 10.1007/s11701-020-01154-8. Epub 2020 
      Oct 12.