Open Access

Meta‑analysis of the effect of antithrombotic drugs on perioperative bleeding in BPH surgery

  • Authors:
    • Qian He
    • Yanlan Yu
    • Fengbin Gao
  • View Affiliations

  • Published online on: August 6, 2020     https://doi.org/10.3892/etm.2020.9102
  • Pages: 3807-3815
  • Copyright: © He et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Effects of antithrombotic agents on the bleeding risk after transurethral resection of the prostate (TURP) were assessed in patients with benign prostatic hyperplasia (BPH). Controlled clinical trials on the effects of perioperative anticoagulant therapy on postoperative bleeding in BPH patients published during January 1990 and February 2019 were searched in PubMed, Embase and the Cochrane Library. Two independent reviewers screened the studies according to the inclusion and exclusion criteria, extracted the data, evaluated the quality, and conducted a meta‑analysis using the RevMan 5.3 software. A total of 20 studies were included. Analysis of these studies found that compared with interrupted use of antithrombotic agents, continuous use of antithrombotic drugs led to more frequent post‑TURP bleeding (OR=4.34, 95% CI=2.29‑8.23), and higher transfusion rate (2.96, 1.19‑7.36). Compared with patients who never used antithrombotic agents, those who used antithrombotic agents continuously had higher bleeding risk (5.52, 1.64‑18.66). Those who continued using antithrombotic agents during laser treatment had higher transfusion rate than those who stopped using them before the operation (5.39, 1.49‑19.53), but it had no significant difference in clot retention, blood transfusion rate, intraoperative hemoglobin decrease and postoperative catheter‑indwelling time compared with those who never used antithrombotic agents (P>0.05). Those who continued using antithrombotic agents during TURP showed less intraoperative hemoglobin decrease (‑0.46, ‑0.58 ‑0.35) than the patients who underwent low molecular weight heparin substitution. Interruption of antithrombotic agents during TURP can prevent the risk of postoperative bleeding; continuous use of antithrombotic agents is safe and feasible during laser treatment of BPH; whether low molecular weight heparin substitution is necessary during the discontinuation of antithrombotic agents is controversial.
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October-2020
Volume 20 Issue 4

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
He Q, Yu Y and Gao F: Meta‑analysis of the effect of antithrombotic drugs on perioperative bleeding in BPH surgery. Exp Ther Med 20: 3807-3815, 2020
APA
He, Q., Yu, Y., & Gao, F. (2020). Meta‑analysis of the effect of antithrombotic drugs on perioperative bleeding in BPH surgery. Experimental and Therapeutic Medicine, 20, 3807-3815. https://doi.org/10.3892/etm.2020.9102
MLA
He, Q., Yu, Y., Gao, F."Meta‑analysis of the effect of antithrombotic drugs on perioperative bleeding in BPH surgery". Experimental and Therapeutic Medicine 20.4 (2020): 3807-3815.
Chicago
He, Q., Yu, Y., Gao, F."Meta‑analysis of the effect of antithrombotic drugs on perioperative bleeding in BPH surgery". Experimental and Therapeutic Medicine 20, no. 4 (2020): 3807-3815. https://doi.org/10.3892/etm.2020.9102