Antikogülan ve Antiagregan İlaç Kullanan Hastalarda Prostat Biyopsi İşlemi: Preop Hasta Hazırlık ve Postop Takip Süreci
Özet
Prostat kanserinin tanısında kullanılan en önemli yöntemlerden bir tanesi transrektal ultrasonografi (TRUS) eşliğinde uygulanan biyopsidir. TRUS ile yapılan prostat biyopsisi, serum PSA değeri yüksek olan ve/veya parmakla rektal muayenede prostat kanser şüphesi olan erkeklerde yapılması endikedir. Yapılan prostat biyopsi operasyonu ardından kanama olması olası komplikasyonlardan biridir, bu komplikasyon olasılığını en aza indirmek için biyopsi işlemi hemen öncesinde hastanın kullandığı ilaçlar sorgulanmalıdır. Anti-agrekan ve antikoagülan ilaç kullanımı biyopsi öncesi kesilmesi veya kullanımının devam etmesi açısından çalışmalar bulunmaktadır.
One of the most important methods used in the diagnosis of prostate cancer is the biopsy performed under transrectal ultrasonography (TRUS) guidance. Prostate biopsy via TRUS is indicated for men with elevated serum PSA levels and/or those with suspected prostate cancer based on digital rectal examination findings. One of the potential complications following prostate biopsy is bleeding. To minimize the risk of this complication, it is essential to inquire about the medications the patient is taking immediately before the biopsy procedure. Research exists regarding the discontinuation or continuation of the use of antiplatelet and anticoagulant medications prior to the biopsy.
Referanslar
Spiess JL. Can I stop the warfarin? A review of the risks and benefits of discontinuing anticoagulation. J Palliat Med 2009; 12:83-87
Ihezue CU, Smart J, Dewbury KC, et al. Biopsy of the prostate guided by transrectal ultrasound: relation between warfarin use and incidence of bleeding complications. Clin Radiol 2005;60:459-463.
Gerstein NS, Schulman PM, Gerstein WH, et al. Should more patients continue aspirin therapy perioperatively? Clinical impact of aspirin withdrawal syndrome. Ann Surg 2012; 255: 811-819.
Maan Z, Cutting CW, Patel U, Kerry S, Pietrzak P, Perry MJ, Kirby RS. Morbidity of transrectal ultrasonography-guided prostate biopsies in patients after the continued use of low-dose aspirin. BJU Int. 2003; 91(9): 798-800.
armignani L, Picozzi S, Bozzini G, et al. Transrectal ultrasound-guided prostate biopsies in patients taking aspirin for cardiovascular disease:a meta-analysis. Transfus Apher Sci 2011;45:275-280.
Herget EJ, Saliken JC, Donnelly BJ, Gray RR, Wiseman D, Brunet G. Transrectal ultrasound-guided biopsy of the prostate: relation between ASA use and bleeding complications. Can Assoc Radiol J 1999;50:173-176.
Rodriguez LV, Terris MK. Risks and complications of transrectal ultrasound guided prostate needle biopsy: a prospective study and review of the literature. J Urol. 1998; 160: 2115-2120.
Meyer JP, Gillat DA, Lush R, Persad R.Managing the warfarinized urological patient. BJU Int. 2003 Sep; 92 (4): 351-354.
Referanslar
Spiess JL. Can I stop the warfarin? A review of the risks and benefits of discontinuing anticoagulation. J Palliat Med 2009; 12:83-87
Ihezue CU, Smart J, Dewbury KC, et al. Biopsy of the prostate guided by transrectal ultrasound: relation between warfarin use and incidence of bleeding complications. Clin Radiol 2005;60:459-463.
Gerstein NS, Schulman PM, Gerstein WH, et al. Should more patients continue aspirin therapy perioperatively? Clinical impact of aspirin withdrawal syndrome. Ann Surg 2012; 255: 811-819.
Maan Z, Cutting CW, Patel U, Kerry S, Pietrzak P, Perry MJ, Kirby RS. Morbidity of transrectal ultrasonography-guided prostate biopsies in patients after the continued use of low-dose aspirin. BJU Int. 2003; 91(9): 798-800.
armignani L, Picozzi S, Bozzini G, et al. Transrectal ultrasound-guided prostate biopsies in patients taking aspirin for cardiovascular disease:a meta-analysis. Transfus Apher Sci 2011;45:275-280.
Herget EJ, Saliken JC, Donnelly BJ, Gray RR, Wiseman D, Brunet G. Transrectal ultrasound-guided biopsy of the prostate: relation between ASA use and bleeding complications. Can Assoc Radiol J 1999;50:173-176.
Rodriguez LV, Terris MK. Risks and complications of transrectal ultrasound guided prostate needle biopsy: a prospective study and review of the literature. J Urol. 1998; 160: 2115-2120.
Meyer JP, Gillat DA, Lush R, Persad R.Managing the warfarinized urological patient. BJU Int. 2003 Sep; 92 (4): 351-354.
