Urology Department, IRCCS Policlinico San Donato, University of Milan, Via Morandi 30, 20097, San Donato Milanese, Milan, Italy,
Surg Endosc. 2014 Jan;28(1):116-21. doi: 10.1007/s00464-013-3136-8. Epub 2013 Sep 4.
Urologists have not reached a consensus regarding the pre-, intra-, and postoperative management of patients taking antiplatelet agents. This study aimed to evaluate the clinical course of patients receiving antithrombotic monotherapy with acetylsalicylic acid (ASA) 100 mg who underwent transurethral resection of bladder cancer.
This study was designed to compare the surgical outcomes for 108 transurethral resections of bladder cancer performed for patients taking antiplatelet therapy and for 105 procedures performed for patients who had never taken antiplatelet agents before surgery. Antiaggregant therapy was maintained according to criteria evaluated by a urologist, surgeon, anesthesiologist, and cardiologist. Variables were described using the mean as the location index and using standard deviation as a dispersion index if continuous percentages were used elsewhere. Group comparisons were performed using the t test or the chi-square test for categorical data, and Fisher's exact test was used where appropriate.
The mean operative time for patients taking ASA was 31 min (range 10-65 min), whereas it was 26 min (range 5-60 min) for control subjects. The difference between pre- and postoperative hemoglobin values was -0.6 g/dl in the group receiving antiplatelet therapy and -0.8 g/dl in the control group (p = 0.0720). Transfusional support was required during four procedures performed for patients taking antiplatelet therapy and during two procedures for the control group (p = 0.242). No adverse cardiac events or anesthesia-related complications occurred. Three patients in the treatment group and two patients in the control group required reintervention to ensure hemostasis during the postoperative period. None of the patients in either group underwent rehospitalization for hematuria after leaving the hospital.
The current results suggest that continued use of anti-aggregant monotherapy does not increase the risk of overall bleeding or reintervention for patients undergoing transurethral resection of bladder neoplasms and that suspending aspirin before such a procedure is therefore unnecessary.
泌尿科医生尚未就服用抗血小板药物的患者的术前、术中和术后管理达成共识。本研究旨在评估接受抗血栓单药治疗（乙酰水杨酸 100mg）的患者接受经尿道膀胱肿瘤切除术的临床过程。
本研究旨在比较 108 例接受抗血小板治疗的患者和 105 例术前从未接受抗血小板药物治疗的患者接受经尿道膀胱肿瘤切除术的手术结果。抗聚集治疗根据泌尿科医生、外科医生、麻醉师和心脏病专家评估的标准进行维持。连续百分比使用位置指数的平均值表示，使用标准差表示离散指数。使用 t 检验或卡方检验对连续变量进行组间比较，使用 Fisher 精确检验进行适当的分类数据比较。
服用 ASA 的患者的平均手术时间为 31 分钟（范围 10-65 分钟），而对照组为 26 分钟（范围 5-60 分钟）。接受抗血小板治疗组的术前和术后血红蛋白值差异为-0.6g/dl，对照组为-0.8g/dl（p=0.0720）。接受抗血小板治疗的 4 例手术和对照组的 2 例手术需要输血支持（p=0.242）。治疗组的 3 例患者和对照组的 2 例患者在术后期间需要再次介入以确保止血。两组患者均无因血尿再次住院。
目前的结果表明，继续使用抗聚集单药治疗不会增加接受经尿道膀胱肿瘤切除术的患者的总出血风险或再次介入的风险，因此在进行该手术前暂停使用阿司匹林是不必要的。
