title: [Perioperative complications of transurethral resection of bladder tumor in patients receiving antithrombotic therapy].
abstract: We examined perioperative complications of transurethral resection of bladder tumor (TURBT) in patients receiving antithrombotic therapy. We retrospectively studied 276 patients who underwent TURBT in our institute from January 2007 to March 2013. The study group consisted of 105 patients (38%) who were receiving antithrombotic agents, and the other 171 patients (62%) without antithrombotic agents were assigned to the control group. The period of discontinuation of antithrombotic agents complied with our institutional rule. The most frequently used agent was aspirin (69 patients : 66%), followed by warfarin (25 patients : 24%). Fourteen patients receiving warfarin (56%) needed heparin bridging therapy. There was no significant difference in average operative time (51 minutes versus 54 minutes), or average days to removal of urethral catheter (3.7 days versus 3.3 days) between the study and control groups. Hemorrhagic and ischemic complications were noted in 11 (10.5%) and 2 (1.9%) patients in the study group and 11 (6.4%) and none (0%) of the patients in the control group, respectively, with no significant difference between the 2 groups. However, prevalence of hemorrhagic complications in patients receiving heparin bridging therapy (21.4%) was significantly higher than that in the control group. Ischemic complications in the study group included chest pain suggestive of angina in one patient and acute myocardial infarction leading to death in another patient. We should pay attention to hemorrhagic complications in patients receiving heparin bridging therapy and keep in mind the possibility of lethal ischemic complications after discontinuation of antithrombotic agents.
authors.affiliation: The Department of Renal and Urologic Surgery, Asahikawa Medical University.
authors.forename: Naoki
authors.initials: N
authors.lastname: Wada
authors.affiliation: The Department of Renal and Urologic Surgery, Asahikawa Medical University.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Okazaki
authors.affiliation: The Department of Renal and Urologic Surgery, Asahikawa Medical University.
authors.forename: Shin
authors.initials: S
authors.lastname: Kobayashi
authors.affiliation: The Department of Renal and Urologic Surgery, Asahikawa Medical University.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Hashizume
authors.affiliation: The Department of Renal and Urologic Surgery, Asahikawa Medical University.
authors.forename: Junichi
authors.initials: J
authors.lastname: Hori
authors.affiliation: The Department of Renal and Urologic Surgery, Asahikawa Medical University.
authors.forename: Makoto
authors.initials: M
authors.lastname: Azumi
authors.affiliation: The Department of Renal and Urologic Surgery, Asahikawa Medical University.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kita
authors.affiliation: The Department of Renal and Urologic Surgery, Asahikawa Medical University.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Iwata
authors.affiliation: The Department of Renal and Urologic Surgery, Asahikawa Medical University.
authors.forename: Seiji
authors.initials: S
authors.lastname: Matsumoto
authors.affiliation: The Department of Renal and Urologic Surgery, Asahikawa Medical University.
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Kakizaki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000453:epidemiology / Q000209:etiology*; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects; D015653:Cystectomy / Q000379:methods; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology*; D011183:Postoperative Complications; D012189:Retrospective Studies; D014521:Urethra; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014859:Warfarin / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D005343:Fibrinolytic Agents; D014859:Warfarin; D006493:Heparin; D001241:Aspirin