Perioperative aspirin safe during robotic partial nephrectomy: Study

Daily aspirin use following cardiovascular intervention is commonplace and creates concern regarding bleeding risk in patients undergoing surgery. Despite its cardio-protective role, aspirin is often discontinued 5–7 days prior to major surgery due to bleeding concerns. Single institution studies have investigated perioperative outcomes of aspirin use in robotic partial nephrectomy (RPN). We sought to evaluate the outcomes of perioperative aspirin (pASA) use during RPN in a multicenter setting.

The researchers performed a retrospective evaluation of patients undergoing RPN at 5 high volume RPN institutions. We compared perioperative outcomes of patients taking perioperative aspirin (pASA) (81 mg) to those, not on aspirin. They analyzed the association between perioperative aspirin (pASA) use and perioperative transfusion.

The Results of the study are:

Of 1,565 patients undergoing RPN, 228 (14.5%) patients continued perioperative aspirin (pASA) and were older (62.8 vs 56.8 years, p <0.001) with higher Charlson scores (mean 3 vs 2, p <0.001). Pperioperative aspirin (pASA) was associated with increased perioperative blood transfusions (11% vs 4%, p <0.001) and major complications (10% vs 3%, p <0.001). On multivariable analysis, perioperative aspirin (pASA) was associated with increased transfusion risk (OR 1.94, 1.10–3.45, 95% CI).

Thus, the researchers concluded that in experienced hands, perioperative aspirin 81 mg use during RPN is reasonable and safe; however, there is a higher risk of blood transfusions and major complications. Future studies are needed to clarify the role of antiplatelet therapy in RPN patients requiring perioperative aspirin (pASA) for primary or secondary prevention of cardiovascular events.

Reference:

Perioperative Aspirin Use Is Associated with Bleeding Complications during Robotic Partial Nephrectomy by Joan C. Delto et al. published in the Journal of Urology.

https://www.auajournals.org/doi/10.1097/JU.0000000000002240