Does Continuation of Low-Dose Aspirin During Robot-Assisted Radical Prostatectomy Compromise Surgical Outcomes?

2018 ◽  
Vol 32 (9) ◽  
pp. 852-858 ◽  
Author(s):  
Ashwin Sunil Tamhankar ◽  
Saurabh Ramesh Patil ◽  
Puneet Ahluwalia ◽  
Gagan Gautam
Keyword(s):  
Radical Prostatectomy ◽  
Surgical Outcomes ◽  
Low Dose ◽  
Robot Assisted ◽  
Dose Aspirin ◽  
Low Dose Aspirin

Aspirin use in robot-assisted radical prostatectomy? Systematic review and metanalysis.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. e553-e553
Author(s):  
Arie Carneiro ◽  
Jonathan Doyun Cha ◽  
Marcelo Langer Wroclawski ◽  
Paulo Priante Kayano ◽  
Oliver Rojas Claros ◽  
...  
Keyword(s):  
Systematic Review ◽  
Radical Prostatectomy ◽  
Low Dose ◽  
Transfusion Rate ◽  
Robot Assisted ◽  
Surgical Morbidity ◽  
Dose Aspirin ◽  
Low Dose Aspirin ◽  
Group A ◽  
Group B

e553 Background: Low dose aspirin (81-100mg) used as secondary prevention in cardiovascular diseases is correlated with increased bleeding and overall complications in surgical procedures. However, the suspension of this medication can increase the risk of cerebrovascular accident and myocardial infarction. Robot-assisted radical prostatectomy (RARP) has significantly decreased the surgical morbidity and the peri-operative bleeding. Our aim was to analyze whether RARP is feasible and safe in patients with low dose aspirin intake. Methods: Systematic review of the literature using MEDLINE, ESCOPUS, Lilacs, Scielo and Cohcrane articles published until June 2016. We included prospective trials and large cohorts that evaluated patients with (Group A) or without the maintenance of aspirin (Group B). Results: 5 trials (n = 1481 men) were included. One thousand and thirteen men stopped the use of the medication and 168 kept it during the peri-operatory setting, including the procedure. For the analyses of overall complications 3 articles with 458 men were included. The overall complication rate was 19%, without statistically significant difference between groups (Group A: 10.5%; Group B: 21.8% - OR: 0.70 IC:0.31- 1.56; I2= 0%). In a sub analysis evaluating major complications (Clavien > 2), cardiovascular events were similar between groups (Group A: 10.5%; Group B: 19% OR: 0.67 IC: 0.34- 1.70; I2= 0%). There were 5 trials included to evaluate blood loss, with 1481 patients (168 Group A and 1313 Group B). The overall transfusion rate was 1.9%, without difference between groups (Group A = 3,5% and Group B = 1.7% - OR:3.24 IC:0.87- 12.06; I2= 0%). The estimate perioperative bleeding rate was significantly lower in patients using aspirin during surgery (OR:-33.74 IC:-44.99, -22.49, I2= 92%). The hospital stay length was similar between groups (OR:0 IC:-0.04, 0.04; I2= 0%). Conclusions: Low dose aspirin does not correlate with larger peri-operatory surgical morbidity, transfusion rate or hospital stay. The blood loss was lower in the aspirin intake group, but this fact should be interpreted with caution due to the high heterogeneity among studies. RARP in patients under continuous aspirin intake was feasible and safe.

Radical Prostatectomy With Robot-assisted Radical Prostatectomy and Laparoscopic Radical Prostatectomy Under Low-dose Aspirin Does Not Significantly Increase Blood Loss

Urology ◽  
2012 ◽  
Vol 79 (3) ◽  
pp. 591-595 ◽  
Author(s):  
Michèle Binhas ◽  
Laurent Salomon ◽  
Françoise Roudot-Thoraval ◽  
Catherine Armand ◽  
Benoît Plaud ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Blood Loss ◽  
Low Dose ◽  
Laparoscopic Radical Prostatectomy ◽  
Robot Assisted ◽  
Dose Aspirin ◽  
Low Dose Aspirin ◽  
Increase Blood Loss

Open and robot-assisted radical retropubic prostatectomy in men receiving ongoing low-dose aspirin medication: revisiting an old paradigm?

2014 ◽  
pp. n/a-n/a ◽  
Author(s):  
Sami-Ramzi Leyh-Bannurah ◽  
Jens Hansen ◽  
Hendrik Isbarn ◽  
Thomas Steuber ◽  
Pierre Tennstedt ◽  
...  
Keyword(s):  
Low Dose ◽  
Radical Retropubic Prostatectomy ◽  
Robot Assisted ◽  
Retropubic Prostatectomy ◽  
Dose Aspirin ◽  
Low Dose Aspirin

Alert Issued on Low-Dose Aspirin + Ibuprofen

2006 ◽  
Vol 34 (10) ◽  
pp. 8
Author(s):  
ELIZABETH MECHCATIE
Keyword(s):  
Low Dose ◽  
Dose Aspirin ◽  
Low Dose Aspirin

Investigation of the Interaction of Blood Platelets with the Coagulation System at the Site of Plug Formation In Vivo in Man - Effect of Low-Dose Aspirin

1987 ◽  
Vol 57 (01) ◽  
pp. 062-066 ◽  
Author(s):  
P A Kyrle ◽  
J Westwick ◽  
M F Scully ◽  
V V Kakkar ◽  
G P Lewis
Keyword(s):  
Platelet Activation ◽  
Thrombin Generation ◽  
Low Dose ◽  
Bleeding Time ◽  
Blood Platelets ◽  
Dose Aspirin ◽  
Low Dose Aspirin ◽  
Plug Formation ◽  
Granule Release

SummaryIn 7 healthy volunteers, formation of thrombin (represented by fibrinopeptide A (FPA) generation, α-granule release (represented by β-thromboglobulin [βTG] release) and the generation of thromboxane B2 (TxB2) were measured in vivo in blood emerging from a template bleeding time incision. At the site of plug formation, considerable platelet activation and thrombin generation were seen within the first minute, as indicated by a 110-fold, 50-fold and 30-fold increase of FPA, TxB2 and PTG over the corresponding plasma values. After a further increase of the markers in the subsequent 3 minutes, they reached a plateau during the fourth and fifth minute. A low-dose aspirin regimen (0.42 mg.kg-1.day-1 for 7 days) caused >90% inhibition of TxB2formation in both bleeding time blood and clotted blood. At the site of plug formation, a-granule release was substantially reduced within the first three minutes and thrombin generation was similarly inhibited. We conclude that (a) marked platelet activation and considerable thrombin generation occur in the early stages.of haemostasis, (b) α-granule release in vivo is partially dependent upon cyclo-oxygenase-controlled mechanisms and (c) thrombin generation at the site of plug formation is promoted by the activation of platelets.

Increased Thromboxane Biosynthesis in Essential Thrombocythemia

1995 ◽  
Vol 74 (05) ◽  
pp. 1225-1230 ◽  
Author(s):  
Bianca Rocca ◽  
Giovanni Ciabattoni ◽  
Raffaele Tartaglione ◽  
Sergio Cortelazzo ◽  
Tiziano Barbui ◽  
...  
Keyword(s):  
Platelet Count ◽  
Platelet Activation ◽  
Essential Thrombocythemia ◽  
Therapeutic Strategy ◽  
Low Dose ◽  
Thrombotic Risk ◽  
Dose Aspirin ◽  
Gender And Age ◽  
Low Dose Aspirin

SummaryIn order to investigate the in vivo thromboxane (TX) biosynthesis in essential thromboeythemia (ET), we measured the urinary exeretion of the major enzymatic metabolites of TXB2, 11-dehydro-TXB2 and 2,3-dinor-TXB2 in 40 ET patients as well as in 26 gender- and age-matched controls. Urinary 11-dehydro-TXB2 was significantly higher (p <0.001) in thrombocythemic patients (4,063 ± 3,408 pg/mg creatinine; mean ± SD) than in controls (504 ± 267 pg/mg creatinine), with 34 patients (85%) having 11-dehydro-TXB2 >2 SD above the control mean. Patients with platelet number <1,000 × 109/1 (n = 25) had significantly higher (p <0.05) 11 -dehydro-TXB2 excretion than patients with higher platelet count (4,765 ± 3,870 pg/mg creatinine, n = 25, versus 2,279 ± 1,874 pg/mg creatinine, n = 15). Average excretion values of patients aging >55 was significantly higher than in the younger group (4,784 ± 3,948 pg/mg creatinine, n = 24, versus 2,405 ± 1,885 pg/mg creatinine, n = 16, p <0.05). Low-dose aspirin (50 mg/d for 7 days) largely suppressed 11-dehydro-TXB2 excretion in 7 thrombocythemic patients, thus suggesting that platelets were the main source of enhanced TXA2 biosynthesis. The platelet count-corrected 11-dehydro-TXB2 excretion was positively correlated with age (r = 0.325, n = 40, p <0.05) and inversely correlated with platelet count (r = -0.381, n = 40, p <0.05). In addition 11 out of 13 (85%) patients having increased count-corrected 11-dehydro-TXB2 excretion, belonged to the subgroup with age >55 and platelet count <1,000 × 1099/1. We conclude that in essential thrombocythemia: 1) enhanced 11-dehydro-TXB2 excretion largely reflects platelet activation in vivo;2) age as well as platelet count appear to influence the determinants of platelet activation in this setting, and can help in assessing the thrombotic risk and therapeutic strategy in individual patients.

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