MP01-15 ANTICOAGULANTS CONTINUED DURING PVP DOES NOT IMPACT THE RISK OF POSTOPERATIVE HEMORRHAGIC COMPLICATIONS: A MULTICENTRIC PROSPECTIVE STUDY
Bibliographic record
Abstract
You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I (MP01)1 Apr 2019MP01-15 ANTICOAGULANTS CONTINUED DURING PVP DOES NOT IMPACT THE RISK OF POSTOPERATIVE HEMORRHAGIC COMPLICATIONS: A MULTICENTRIC PROSPECTIVE STUDY Benjamin Pradere*, Richard Naspro, Benoit Peyronnet, Julien Guillotreau, Benoit Bordier, Kevin Zorn, and Vicent Misrai Benjamin Pradere*Benjamin Pradere* More articles by this author , Richard NasproRichard Naspro More articles by this author , Benoit PeyronnetBenoit Peyronnet More articles by this author , Julien GuillotreauJulien Guillotreau More articles by this author , Benoit BordierBenoit Bordier More articles by this author , Kevin ZornKevin Zorn More articles by this author , and Vicent MisraiVicent Misrai More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000554879.21629.91AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Photovaporisation of the prostate (PVP) by Greenlight laser has been developed especially to allow a better control of hemostasis during prostate vaporization. Nevertheless, perioperative management of anticoagulants (AC) is still debated, particularly the possibility of continuing AC during this period. The objective of our study was to assess the impact of continued AC on hemorrhagic complications. METHODS: All patients under anticoagulants (NOAC and AVK) operated by PVP in two centers have been included prospectively. Patients characteristics were collected including the type of AC and if it was stopped, continued or bridged. Intraoperative and postoperative complications including hemorrhagic complications, were reported according to the Clavien-Dindo classification and divided in minor complications (<3) and major complications (≥3). Two groups were analyzed and compared: AC continued and AC stopped. Chi2 test (or Fisher) were used for qualitative variables and t-test was used for quantitative variables. RESULTS: Among 185 patients from the cohort, 64 were under AC (AVK n=57, NOAC n=7). Among them, 59% had their treatment stopped or bridged with heparin (LWMH) and 41% had their treatment continued during all the perioperative period. Preoperative patient’s characteristics were similar in both groups. For complications, there was no difference between groups (37% vs. 46%; p=0.45) even for major complications (p=0.79). Hemorrhagic complications were also similar between groups: overall hemorrhagic complications 16% vs. 23% (p=0.46) or intravesical clotting (p=0.79). Functional outcomes at 6 months were also similar. CONCLUSIONS: PVP for patients under AC is feasible. Continuing AC without a stop or a bridge during the perioperative period do not increase significantly the risk of postoperative complications and especially hemorrhagic complications. These results could be considered to go to a simplified management of patients under AC, suggesting that AC could be continued for these fragile patients. Source of Funding: none Tours, France; Bergamo, Italy; Rennes, France; Toulouse, France; Montréal, Canada; Toulouse, France© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e7-e7 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Benjamin Pradere* More articles by this author Richard Naspro More articles by this author Benoit Peyronnet More articles by this author Julien Guillotreau More articles by this author Benoit Bordier More articles by this author Kevin Zorn More articles by this author Vicent Misrai More articles by this author Expand All Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".