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Introduction:
Robotic surgery is increasingly performed for radical prostatectomy and nephrectomy. Many patients have significant cardiac histories requiring aspirin and have significant thromboembolic risk when it is held. Our Objective is to provide the first evaluation of the safety of aspirin in the perioperative period for robotic prostatectomy and nephrectomy.
Materials & Methods:
A retrospective study of a pre-existing prospectively collected quality improvement database was performed. All patients who underwent robotic radical prostatectomy or robotic nephrectomy by a single surgeon between August 2008 and August 2010 were identified. We compared patients operated after November 2009 in whom aspirin had been administered the day of surgery with those who underwent surgery before November 2009 in whom aspirin had been held. Kruskall-Wallis tests or 2-sample T-tests were used to compare continuous variables.
Results:
We identified 44 patients who underwent prostatectomy without recent aspirin and 51 who received preoperative aspirin. There were no significant differences between the 2 groups in baseline characteristics. Operative time (182 vs 174 min, p=0.19), median blood loss (175 vs 100 mL, p=0.12), and length of hospital stay (1 vs 1 day, p=0.08) were similar between the 2 groups. In the nephrectomy cohort, 12 patients had not received aspirin and 14 had. Again, there were no differences in median blood loss (65 vs 50 mL, p=0.96), median operative time (176 vs 140 min, p=0.14), or median hospital stay (2 vs 2 days, p=0.74).
Conclusions:
Continuing aspirin in patients undergoing robotic radical prostatectomy and radical nephrectomy appears to be safe.