Department of Urology, Kokura Memorial Hospital, Fukuoka, Japan.
Department of Urology, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan.
Asian J Endosc Surg. 2023 Oct;16(4):679-686. doi: 10.1111/ases.13218. Epub 2023 Jun 20.
The number of patients receiving antiplatelet therapy (APT) who have undergone laparoscopic radical nephrectomy is increasing. However, it is unclear whether APT affects the outcomes of patients undergoing radical nephrectomy. We investigated the perioperative outcomes of radical nephrectomy in patients with and without APT.
We retrospectively collected data from 89 Japanese patients who underwent laparoscopic radical nephrectomy for clinically diagnosed renal cell carcinoma (RCC) at Kokura Memorial Hospital between March 2013 and March 2022. We analyzed information related to APT. We divided the patients into two groups: the APT group (patients receiving APT) and the N-APT group (patients not receiving APT). Moreover, the APT group was further divided into the C-APT group (patients with continuous APT) and the I-APT group (patients with interrupted APT). We compared the surgical outcomes of these groups.
Among 89 patients eligible for the study, 25 received APT and 10 continued APT. Even though the patients who received APT had a high American Society of Anesthesiologists physical status and many complications, including smoking, diabetes, hypertension, and chronic heart failure, no significant difference in the intra- or postoperative outcomes, including bleeding complications, was observed regardless of whether the patients received APT or continued APT.
We concluded that in laparoscopic radical nephrectomy, continuation of APT is an acceptable strategy for patients with thromboembolic risk caused by interruption of APT.
接受抗血小板治疗(APT)的腹腔镜根治性肾切除术患者数量正在增加。然而,尚不清楚 APT 是否会影响根治性肾切除术患者的结局。我们研究了有和无 APT 的患者行根治性肾切除术的围手术期结局。
我们回顾性收集了 2013 年 3 月至 2022 年 3 月期间在久留米纪念医院接受腹腔镜根治性肾切除术治疗临床诊断为肾细胞癌(RCC)的 89 例日本患者的数据。我们分析了与 APT 相关的信息。我们将患者分为两组:APT 组(接受 APT 的患者)和 N-APT 组(未接受 APT 的患者)。此外,APT 组进一步分为 C-APT 组(持续 APT 的患者)和 I-APT 组(间断 APT 的患者)。我们比较了这些组的手术结局。
在 89 例符合研究条件的患者中,有 25 例接受了 APT,10 例患者持续接受 APT。尽管接受 APT 的患者美国麻醉医师协会身体状况评分较高,且合并多种并发症,包括吸烟、糖尿病、高血压和慢性心力衰竭,但无论患者是否接受 APT 或持续接受 APT,术中或术后结局,包括出血并发症,均无显著差异。
我们的结论是,在腹腔镜根治性肾切除术中,对于因 APT 中断而有血栓栓塞风险的患者,继续 APT 是一种可接受的策略。