The effect of antiplatelet therapy on outcomes in patients who underwent laparoscopic radical nephrectomy: A Japanese single-center study

Asian J Endosc Surg. 2023 Oct;16(4):679-686. doi: 10.1111/ases.13218. Epub 2023 Jun 20.

Abstract

Objectives: 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.

Methods: 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.

Results: 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.

Conclusions: We concluded that in laparoscopic radical nephrectomy, continuation of APT is an acceptable strategy for patients with thromboembolic risk caused by interruption of APT.

Keywords: antiplatelet therapy; laparoscopic radical nephrectomy; renal cell carcinoma.

MeSH terms

  • Blood Loss, Surgical
  • Carcinoma, Renal Cell* / surgery
  • East Asian People
  • Humans
  • Kidney Neoplasms* / surgery
  • Laparoscopy
  • Nephrectomy*
  • Platelet Aggregation Inhibitors* / therapeutic use
  • Retrospective Studies

Substances

  • Platelet Aggregation Inhibitors