Outcomes in patients undergoing nephrectomy for renal cancer on chronic anticoagulation therapy

J. P. Sfakianos*, A. A. Hakimi, P. H. Kim, E. C. Zabor, R. Mano, M. Bernstein, M. Karellas, P. Russo

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Aims To report our experience on surgical resection of renal tumors for patients with a history of chronic anticoagulation (ACT) or aspirin use. Methods We performed a retrospective analysis of 2473 patients who underwent surgery for renal tumors between 2005 and 2012. Prior to surgery, 172 were on chronic ACT and 695 on aspirin. Multivariable linear and logistic regression models were used to compare transfusion and overall complication rates between patients undergoing renal surgery who were on therapy to patients who were on aspirin and to patients with no therapy. Results Compared to no therapy and aspirin patients those on ACT were older (57.3 (IQR 48.4-66.10) vs 63.9, (IQR 57.3-71.5) vs 68.4, (IQR 60.4-73.5); p < 0.001), with a higher percentage having an ASA score of 3 or 4 (42.4 vs 57.9 vs 82.6%; p < 0.001), respectively. ACT patients had a higher 30-day transfusion rate, 22.7% vs 7.6% vs 6.9%, and 90-day complication rate, 17.4% vs 7.2% vs 7.3%, both p < 0.001. The median length of stay differed statistically between groups (p < 0.001), with a modest longer stay in the anticoagulation group (OR 1.11 SE 0.26; p < 0.001). Transfusion and complication rates for patients on therapy undergoing minimally invasive surgery vs open surgery were not statistically different. Conclusions Patients on chronic ACT had higher transfusion and overall complication rates compared to patients on no treatment or on chronic aspirin. These findings did not correlate to clinical differences in length of stay or grade 3-5 complications.

Original languageEnglish
Pages (from-to)1700-1705
Number of pages6
JournalEuropean Journal of Surgical Oncology
Volume40
Issue number12
DOIs
StatePublished - 1 Dec 2014
Externally publishedYes

Keywords

  • Anticoagulants
  • Intraoperative complications
  • Kidney neoplasms
  • Nephrectomy

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