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- Title
Transient cessation of antiplatelet medication before percutaneous stone surgery: does it have any safety concern on bleeding related problems?
- Authors
Sahin, Cahit; Can, Utku; Eryildirim, Bilal; Sarica, Kemal
- Abstract
To evaluate the short term effects of transient AP medication cessation on the safety of percutaneous nephrolithotomy (PCNL) and evaluate them with normal cases in a comparative manner. 71 cases undergoing PCNL for renal pelvic stones were divided into two groups: Group 1 ( n: 35) Cases under AP medication (100 mg/day acetyl salicylic acid) in whom the medication was stopped for 7 days before PCNL procedure. Group 2 ( n: 36) Cases without any AP medication prior to PCNL. Coagulation test parameters were normal in all cases prior to stone removal. Treatment related parameters with an emphasis on post-operative course were evaluated between two groups. While prolonged macroscopic hematuria (mean 3.5 days) was present in a 25.7 % of the cases in Group 1; it was 5.7 % in Group 2 (mean 2 days). Mean duration of nephrostomy tube was longer in Group 1 (3.49 vs 2.64 days respectively). Additionally, hospitalization period was longer in cases under antiplatelet therapy when compared with the others. No statistically significant difference was noted between two groups regarding post-operative Hb drop rates, transfusion, fever, embolization rates. Lastly, of all the risk factors evaluated; use of AP medication was found to increase the risk of macroscopic hematuria 5.8-fold on logistic regression analysis. Our findings demonstrated that despite the cessation of the antiplatelet agents with an appropriate regimen; these cases should be followed for the risk of prolonged hematuria and tube drainage after PCNL in a very close manner.
- Subjects
KIDNEY stones diagnosis; TREATMENT of calculi; PLATELET aggregation inhibitors; HEMATURIA; PERCUTANEOUS nephrolithotomy
- Publication
Urolithiasis, 2017, Vol 45, Issue 4, p371
- ISSN
2194-7228
- Publication type
Article
- DOI
10.1007/s00240-016-0921-6