Introduction: Patients undergoing robo-tic radical prostatectomy (RARP) who require chronic anticoagulant therapy due to cardio-vascular conditions were evaluated for surgical outcomes.
Materıal and Methods: In this study, 200 patients who underwent robotic radical prosta-tectomy with a diagnosis of prostate cancer bet-ween 2008 and 2012, were analyzed. In the first group, low molecular weight heparin (LMWH) was begun to be given to the patients by inter-rupting their use of oral anticoagulant therapy a week earlier than the surgery. The use of low molecular weight heparin was maintained abo-ut a week more after the surgery. The second group included patients who have no history of chronic use of oral anticoagulants therapy. To these patients, low molecular weight hepa-rin as prophylactic was used subcutaneously a day before the surgery and continued until the mobilization. Operative time, blood loss, drain removal time, complication rates, length of hos-pital stay were compared between two groups.
Results: In this study, 24 patients were using oral anticoagulant therapy. Mean operati-ve time was 212,4 min in group 1 and 212,7 min in group 2 (p=0.86). Estimated blood loss was 205 ml and 223 ml in group 1 and 2, respectively (p=0.66). The drain was removed after 2.6 days in group 1 and 2.2 days in group 2. (p=0.08). The length of stay was a mean of 3.8 and 3.2 days in group 1 and 2 respectively (p=0.09). Total complication rate of both groups were 16%. In addition, no statistical difference was observed between minor and major complication rates.
Conclusion: Robotic radical prostatectomy can be safely performed in patients who are at the risk of surgery and have been using chronic oral anticoagulant therapy.
Key Words: Prostatectomy, robotic, antico-agulant
Abstract
Introduction: Patients undergoing robo-tic radical prostatectomy (RARP) who require chronic anticoagulant therapy due to cardio-vascular conditions were evaluated for surgical outcomes.
Materıal and Methods: In this study, 200 patients who underwent robotic radical prosta-tectomy with a diagnosis of prostate cancer bet-ween 2008 and 2012, were analyzed. In the first group, low molecular weight heparin (LMWH) was begun to be given to the patients by inter-rupting their use of oral anticoagulant therapy a week earlier than the surgery. The use of low molecular weight heparin was maintained abo-ut a week more after the surgery. The second group included patients who have no history of chronic use of oral anticoagulants therapy. To these patients, low molecular weight hepa-rin as prophylactic was used subcutaneously a day before the surgery and continued until the mobilization. Operative time, blood loss, drain removal time, complication rates, length of hos-pital stay were compared between two groups.
Results: In this study, 24 patients were using oral anticoagulant therapy. Mean operati-ve time was 212,4 min in group 1 and 212,7 min in group 2 (p=0.86). Estimated blood loss was 205 ml and 223 ml in group 1 and 2, respectively (p=0.66). The drain was removed after 2.6 days in group 1 and 2.2 days in group 2. (p=0.08). The length of stay was a mean of 3.8 and 3.2 days in group 1 and 2 respectively (p=0.09). Total complication rate of both groups were 16%. In addition, no statistical difference was observed between minor and major complication rates.
Conclusion: Robotic radical prostatectomy can be safely performed in patients who are at the risk of surgery and have been using chronic oral anticoagulant therapy.
Key Words: Prostatectomy, robotic, antico-agulant