# The efficacy of continuing aspirin in the perioperative period during percutaneous nephrolithotomy: A systematic review and meta-analysis

## TL;DR

This study finds that continuing aspirin during kidney stone surgery does not significantly increase risks of complications or blood loss.

## Contribution

The study provides a meta-analysis on aspirin use during percutaneous nephrolithotomy, addressing a gap in perioperative safety evidence.

## Key findings

- No significant difference in blood loss or hemoglobin levels between aspirin users and controls.
- Continuing aspirin does not increase the risk of postoperative complications or transfusion needs.
- More research is needed due to limited data and high variability in hospital stay outcomes.

## Abstract

The present study was conducted to assess the safety of continuing aspirin during percutaneous nephrolithotomy (PCNL).

PubMed, CENTRAL, Scopus, Embase, and Web of Science were searched for relevant studies up to 5th February 2025. Random-effects meta-analysis was conducted for change in hemoglobin, blood loss, length of hospital stay, complications, need for transfusion and postoperative thrombotic events between patients continuing aspirin vs patients not on any antithrombotic therapy in the perioperative period (controls).

Six studies were included. Meta-analysis showed no statistically significant difference in change in hemoglobin levels (MD: -0.03 95% CI: -0.24, 0.18 I2=31%), estimated blood loss (MD: -6.91 95% CI: -14.36, 0.54 I2=0%), length of hospital stay (MD: -0.31 95% CI: -0.99, 0.37 I2=94%), all complications (OR: 1.29 95% CI: 0.94, 1.79 I2=0%), serious complications (OR: 1.95 95% CI: 0.88, 4.29 I2=38%), bleeding complications (OR: 1.11 95% CI: 0.71, 1.73 I2=0%), need for transfusion (OR: 1.10 95% CI: 0.62, 1.94 I2=0%), and postoperative thrombotic events (OR: 1.30 95% CI: 0.21, 8.24 I2=36%) between patients continuing aspirin and controls.

Continuing aspirin during the perioperative period may not increase the risk of adverse outcomes of PCNL. However, given the scarce data further prospective and Multi-Centre studies are needed to improve the quality of evidence.