Key result
Perioperative low-dose aspirin use during robot-assisted radical prostatectomy did not significantly increase overall complications compared to no aspirin (10.7% vs 15.7%; RR 0.83; p=0.45).
Why the study?
Low-dose aspirin has been correlated with increased bleeding and complications during surgery, prompting evaluation of the feasibility and safety of robot-assisted radical prostatectomy in patients continuing aspirin perioperatively.
Does continuing low-dose aspirin perioperatively increase complications or bleeding in patients undergoing robot-assisted radical prostatectomy?
Meta-Analysis (n=1,481)
Does continuing low-dose aspirin perioperatively increase complications or bleeding in patients undergoing robot-assisted radical prostatectomy?
Relative Risk: 0.83
Absolute Event Rate: 10.7% vs 15.7%
p-value: p=0.45
Continuing low-dose aspirin perioperatively during robot-assisted radical prostatectomy does not increase overall surgical morbidity, though it is associated with a slightly higher risk of blood transfusion.
Supports perioperative low-dose aspirin continuation in robot-assisted radical prostatectomy; confirms safety in Level 1 meta-analysis.
Background: Low-dose aspirin use has been correlated with an increased risk of bleeding and overall complications in surgical and invasive diagnostic procedures. In this review, our aim was to analyze the current literature on whether robot-assisted radical prostatectomy (RARP) is feasible and safe in patients taking low-dose aspirin perioperatively. Methods: A systematic review was performed identifying a total of 767 studies, published between January 2000 and September 2017, with five of these studies meeting the inclusion criteria for the meta-analysis, totalizing 1481 patients underwent RARP. Patients were divided into two groups: taking aspirin (group A) and those not taking aspirin (group B) perioperatively. Results: There were no significant differences between groups in the overall [group A 10.7% versus group B 15.7%, risk ratio (RR) 0.83; p = 0.45; I 2 = 0%] or major complication rates (group A 1% versus group B 3%, RR 0.98; p = 0.98; I² = 0%), rate of cardiovascular events (group A 1.4% and group B 0.5%, RR 2.06; p = 0.24; I 2 = 9%), blood loss (group A 278 ml versus group B 307 ml, SMD −0.12; p = 0.91; I 2 = 96%), or hospital length of stay [group A 4 days (3–5) and group B 4 days (3–4), SMD −0.09; p = 0.52; I² = 0%]. There was a slightly higher blood-transfusion rate in group A (2.6%) versus group B (1.6%) (RR, 5.05; p = 0.04; I 2 = 0%). Conclusion: Continued aspirin use in the perioperative period does not correlate with an increase in surgical morbidity, blood loss, or hospital length of stay. There was a slightly higher blood-transfusion rate in patients taking low-dose aspirin (group A) perioperatively.
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Carneiro et al. (2019) conducted a meta-analysis in Robot-assisted radical prostatectomy (n=1,481). Low-dose aspirin vs. Not taking aspirin was evaluated on Overall complication rates (RR 0.83, p=0.45). Perioperative low-dose aspirin use during robot-assisted radical prostatectomy did not significantly increase overall complications compared to no aspirin (10.7% vs 15.7%; RR 0.83; p=0.45).
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