Preoperative Aspirin Is Safe in Patients Undergoing Urologic Robot-Assisted Surgery

PURPOSE: To determine the impact of preoperative aspirin on bleeding and other complications in patients undergoing robot-assisted radical prostatectomy and nephrectomy. PATIENTS AND METHODS: We identified all patients who underwent robot-assisted radical prostatectomy or robot-assisted nephrectomy by a single surgeon between August 2008 and August 2010. We compared patients in whom aspirin had not been administered for 7 days with those who received aspirin the morning of surgery. Patients on other antiplatelet agents or anticoagulants were excluded. RESULTS: Forty-four patients underwent prostatectomy without recent aspirin, and 51 received preoperative aspirin. There were no significant differences between the two groups in terms of age, body mass index, American Society of Anesthesiologists score, prostate-specific antigen level, or highest Gleason score. Operative time (182 vs 174 min, P=0.19), median blood loss (175 vs 100 mL, P=0.12), and duration of hospital stay (1 vs 1 day, P=0.08) were similar between the two groups, respectively. No patient received a transfusion. Three patients who had not received aspirin and one who had were readmitted within 30 days. In the nephrectomy cohort, 12 patients had not received aspirin and 14 had. There were no differences in median blood loss (65 vs 50 mL, P=0.96), median operative time (176 vs 140 min, P=0.14), or median hospital stay (2 vs 2 days, P=0.74). No patient received a transfusion. CONCLUSIONS: The administration of aspirin to patients undergoing robot-assisted radical prostatectomy and nephrectomy appears to be safe. The risk of cardiovascular complications resulting from stopping aspirin may exceed the risk of perioperative bleeding and associated complications.