Antikoagülan ve Antiagregan İlaç Kullanan Hastalarda Transüretral Prostat Rezeksiyonu Operasyonu: Preoperatif Hasta Hazırlık ve Postoperatif Takip Süreci

Demirhan Örsan Demir

doi:10.37609/akya.3286

Yazarlar

Demirhan Örsan Demir

https://orcid.org/0000-0001-8369-0059

DOI: https://doi.org/10.37609/akya.3286.c11879

Özet

80 cc’ nin altında prostat hacmi olan, medikal tedaviye yanıt vermeyen ve cerrahi planlanan benign prostat hiperplazisi (BPH) olan hastalarda altın standart cerrahi transüretral prostat rezeksiyonudur. BPH genellikle ileri yaşta görülen bir hastalık olduğundan sıklıkla komorbid hastalıklara eşlik eder. Bu hastaların azımsanmayacak bir kısmı oral antikoagülan ve platelet agregasyon inhibitörü gibi antitrombotik ilaçlar kullanmaktadır. Antitrombotik ilaçların kullanımı da kesilmesi de peroperatif ve postoperatif dönemde çeşitli komplikasyonlara yol açabilir. Antikoagülanlar ve platelet agregasyon inhibitörleri etki mekanizmaları farklı olsa da temelde kanın pıhtılaşma süresini uzatarak arteryel ve venöz tromboz riskini azaltırlar. Antitrombotik ilaçlar tromboembolik komplikasyon riskini azaltsa da peroperatif ve postoperatif hemorajiyi artırdıklarından bu ilaçları kullanan hastalar preoperatif süreçte iyi hazırlanmalı ve postoperatif yakın takip edilmelidir.

The gold standard surgery for patients with benign prostatic hyperplasia (BPH), who have a prostate volume below 80 cc, who do not respond to medical treatment, and who are planned for surgery, is transurethral prostate resection. Since BPH is a disease that usually occurs in older ages, it often accompanies comorbid diseases. A significant portion of these patients use antithrombotic drugs such as oral anticoagulants and platelet aggregation inhibitors. The use and discontinuation of antithrombotic drugs may also lead to various complications in the perioperative and postoperative periods. Although anticoagulants and platelet aggregation inhibitors have different mechanisms of action, they basically reduce the risk of arterial and venous thrombosis by prolonging blood clotting time. Although antithrombotic drugs reduce the risk of thromboembolic complications, since they increase peroperative and postoperative hemorrhage, patients using these drugs should be well prepared in the preoperative period and closely monitored postoperatively.

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