Safety and Complications of Continuation of Aspirin Therapy in Patients Undergoing Robot-Assisted Laparoscopic Simple Prostatectomy

Abstract

Objective To evaluate the safety and feasibility of continued perioperative aspirin at the time of robotic assisted simple prostatectomy (RASP). Materials and Methods We performed a retrospective review of our IRB approved institutional database of patients who underwent RASP between 2013 to 2022. Comparative groups included patients taking aspirin continued in the perioperative period and those not taking aspirin pre-operatively. The primary outcome was any post-operative bleeding related complication using the modified Clavien-Dindo classification. Secondary outcomes included the identification of risk factors for increased blood loss in the entire study population, operative time, and blood transfusion requirement. Results 143 patients underwent RASP of which 55 (38.5%) patients had continued perioperative aspirin therapy and 88 (61.5%) patients did not take perioperative aspirin. Baseline demographics were similar between the groups. Patients taking perioperative aspirin had a higher rate of hypertension (74.5% vs 58.0%, p = 0.04) and other cardiovascular disease (30.9% vs 11.4%, p = 0.007). Postoperative complications were similar between the groups (Clavien Dindo ³ 3; p = 0.43). Median blood loss (150 cc vs 150 cc, p = 0.38), percentage drop in hemoglobin (13.4 vs 13.2, p = 0.94) and blood transfusion rate (3.6 vs 1.1, p = 0.56) were similar between the two groups. The median blood loss was 150 ml for the whole study population. On regression analysis, neither aspirin nor any other variable was associated with increased blood loss (> 150 ml). Conclusions Aspirin can be safely continued perioperatively in patients undergoing RASP without any risk of bleeding related complications, blood loss, or increased transfusion rate.