Safety of percutaneous nephrolithotomy in patients on chronic anticoagulant or antiplatelet therapy

The objective of this study is to analyze whether PNL surgery is a safe procedure in patients under a treatment discontinuation protocol for anticoagulant or antiplatelet therapies. We retrospectively studied 301 patients who underwent PNL i n our hospital between 2008 and 2016 and identified 46 patients on chronic antiplatelet or anticoagulation treatment. With respect to PNL outcomes, the stone-free rate was similar (78 vs 74%,p = 0.762) in both groups, without any significant differences in the overall postoperative complications (17 vs 26%,p = 0.203). The incidence of hemorrhagic complications was similar between groups (12 vs 9%,p = 0.492), as demonstrated by the mean drop in hemoglobin (Hb), which was comparable in both cohorts (2.2 ± 1.3 vs 2.0 ± 1.4p = 0.270) and the blood transfusion rate (14% in group A and 8% in group B,p = 0.205). No thromboembolic events were found within the year after the PNL procedure. PNL is a safe and effective intervention in patients under a treatment discontinuation protocol for anticoagulant or antiplatelet therapies. Although our study demonstrates the feasibility of this protocol, n ew scientific evidence aims to stratify the thromboembolic and bleeding risk of each patient to individualize the perioperative management thereafter.
Source: Urolithiasis - Category: Urology & Nephrology Source Type: research