The efficacy of continuing aspirin in the perioperative period during percutaneous nephrolithotomy: A systematic review and meta-analysis.

OBJECTIVE

The present study was conducted to assess the safety of continuing aspirin during percutaneous nephrolithotomy (PCNL).

METHODS

PubMed, CENTRAL, Scopus, Embase, and Web of Science were searched for relevant studies up to 5 February 2025. Random-effects meta-analysis was conducted for change in hemoglobin, blood loss, length of hospital stay, complications, need for transfusion and postoperative thrombotic events between patients continuing aspirin vs patients not on any antithrombotic therapy in the perioperative period (controls).

RESULTS

Six studies were included. Meta-analysis showed no statistically significant difference in change in hemoglobin levels (MD: -0.03 95% CI: -0.24, 0.18 I=31%), estimated blood loss (MD: -6.91 95% CI: -14.36, 0.54 I=0%), length of hospital stay (MD: -0.31 95% CI: -0.99, 0.37 I=94%), all complications (OR: 1.29 95% CI: 0.94, 1.79 I=0%), serious complications (OR: 1.95 95% CI: 0.88, 4.29 I=38%), bleeding complications (OR: 1.11 95% CI: 0.71, 1.73 I=0%), need for transfusion (OR: 1.10 95% CI: 0.62, 1.94 I=0%), and postoperative thrombotic events (OR: 1.30 95% CI: 0.21, 8.24 I=36%) between patients continuing aspirin and controls.

CONCLUSIONS

Continuing aspirin during the perioperative period may not increase the risk of adverse outcomes of PCNL. However, given the scarce data further prospective and Multi-Centre studies are needed to improve the quality of evidence.