抗血栓薬内服患者における経尿道的膀胱腫瘍切除術の周術期合併症

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タイトル別名
  • Perioperative Complications of Transurethral Resection of Bladder Tumor in Patients Receiving Antithrombotic Therapy
  • コウケッセンヤク ナイフク カンジャ ニ オケル ケイ ニョウドウテキ ボウコウ シュヨウ セツジョジュツ ノ シュウジュツキ ガッペイショウ

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抄録

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.

収録刊行物

  • 泌尿器科紀要

    泌尿器科紀要 60 (11), 531-535, 2014-11

    泌尿器科紀要刊行会

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