Venous thromboprophylaxis in urological cancer surgery

Michalski, Wojciech; Poniatowska, Grażyna; Jońska-Gmyrek, Joanna; Kucharz, Jakub; Stelmasiak, Pawel; Nietupski, Karol; Ossolinska-Skurczynska, Katarzyna; Sobieszczuk, Michal; Demkow, Tomasz; Wiechno, Paweł

doi:10.1007/s12032-019-1331-8

Cited by 4 publications

(6 citation statements)

References 40 publications

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“…The malignancy-induced hypercoagulability, older age, major pelvic surgery, and cisplatin-based chemotherapy may all contribute to the higher risk [ 12 ]. The nature of malignant tumor disease and the method of endoscopic surgery can cause hypercoagulable blood, and the duration and complexity of surgery are important factors affecting the risk of postoperative DVT [ 13 ]. Intermittent pneumatic compression devices applied in ERAS period emulate muscle contraction, enhancing blood flow in the femoral and popliteal veins and reducing venous stasis.…”

Section: Discussionmentioning

confidence: 99%

Effect of RARC-ERAS nursing program on clinical outcomes in patients undergoing RARC surgery: a retrospective, propensity matching study

He,

Zhou,

et al. 2024

J Robotic Surg

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Currently, there is no specific perioperative nursing standard for RARC based on the ERAS concept. This retrospective study investigates to analyze the effect of RARC-ERAS nursing program on VTE and other clinical outcomes in patients undergoing RARC surgery. This retrospective study included 216 patients undergoing RARC surgery From January 1, 2022 to December 30, 2023, and propensity score adjustment analysis was applied. The study compares a control group receiving traditional nursing and an observation group receiving RARC-ERAS nursing program. Perioperative variables and other postoperative complications were retrieved from the hospital medical records. After propensity score matching, there were no significant differences in the demographic and clinical characteristics between the two groups (p > 0.05). The ERAS group exhibited aa significantly higher rate of postoperative unobstructed venous blood flow in the lower extremities by color Doppler ultrasound as compared to the control group (94.6% VS 80.4%, p = 0.042). Before anesthesia induction, lower preoperative anxiety and surgical information needs scores were observed in the ERAS group than in the control group (p < 0.05). Compared to the control group, the ERAS group demonstrated a shorter surgical duration, a lower incidence of perioperative hypothermia, less time needed for getting out of bed, anal exhaust, and for defecation after returning to the ward (p < 0.05). RARC-ERAS nursing program significantly increased the rate of postoperative unobstructed venous blood flow in the lower extremities by color doppler ultrasound, lower preoperative anxiety and intraoperative hypothermia in patients undergoing RARC. This nursing approach presents a valuable strategy for enhancing patient outcomes and merits further exploration in clinical practice.Trial registration:ChiCTR2400081118; http://www.chictr.org.cn, Principal investigator: Mang-mang He, Date of registration: Feb 22, 2024.

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Section: Discussionmentioning

confidence: 99%

Effect of RARC-ERAS nursing program on clinical outcomes in patients undergoing RARC surgery: a retrospective, propensity matching study

He,

Zhou,

et al. 2024

J Robotic Surg

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“…Despite these low incidence rates, extended thromboprophylaxis is typically recommended in urologic surgery. 37,38 A study that evaluated the association between surgery duration and the risk of VTE in cancer patients was reported. Longer surgical procedures are linked to an increased risk of DVT in the lower extremities.…”

Section: Discussionmentioning

confidence: 99%

Correlation between type of surgery and incidence of postoperative venous thromboembolism (VTE)

Supomo,

Budi Mulyono,

Usi Sukorini

et al. 2024

InaJBCS

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Venous thromboembolism (VTE) is a significant complication in patients after undergoing major surgery. The type of surgery is believed correlated with the incidence of VTE. This study aimed to evaluate the correlation between type of surgery and incidence of VTE among patients who underwent major surgery. It was a retrospective study conducted in Dr. Sardjito General Hospital, Yogyakarta using medical record data of patients who underwent major surgery and were diagnosed with VTE between 2016 and 2020. Patients were grouped by surgery type, and length of stay (LoS). All caused deaths were also analyzed. Among 29,120 patients who underwent major surgery, 76 (0.26%) experienced VTE with females patients accounting for 75%. The mean age of the patients was 55 yr. All VTE cases had the mean LoS of 25 d. The highest proportion of patients who experienced VTE were patients who underwent tumor removal (67.0%) followed by trauma patients (18.4%). A significant difference in the incidence of mortality between the surgical groups was reported (p = 0.02). Post-cardiology had the highest risk of mortality (OR=7.46; 95% CI: 0.322 - 172.61) while age had the lowest risk of mortality (OR=1.01; 95% CI: 0.953 - 1.071). In conclusion, surgery type is correlated with the incidence of VTE. Surgery due to cancer and trauma has a higher risk of VTE compared to the others.

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“…The majority of symptomatic DVT originate in calf veins, and might extend to the proximal leg. If untreated, proximal VTE can develop PE in up to 50% of cases [1,4]. DVT is a major preventable cause of mortality and morbidity worldwide.…”

Section: тромбопрофілактика в урологічній та андрологічній хірургії (...mentioning

confidence: 99%

“…After a PE, 2-4% of patients will develop chronic pulmonary hypertension. Between 17% and 25% of PEs are fatal and PE remains the most common form of preventable hospital mortality [4].…”

Section: тромбопрофілактика в урологічній та андрологічній хірургії (...mentioning

confidence: 99%

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Thromboprophylaxis in Urological and Andrological Surgery (Review article)

Valerii

2022

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Last decades urologist started to performed big amount of complicated oncological operation with substantial risk of both venous thromboembolism (VTE) and bleeding. Prophylaxis of VTE remains a vital problem, as it is potentially fatal and is associated with significant morbidity. Prophylaxis of this complication is not clearly defined and is mainly based on information from other surgical specialties (like orthopedic or general surgery). Scientific publications dedicated VTE prophylaxis in field of urology were reported only in the last decade. Most studies showed that pharmacological prophylaxis decreases the relative risk of VTE in surgical patients by approximately 50%, but with an increase in the relative risk of postoperative major bleeding of 50%. Main models for evaluation of different VTE risk factors were analyzed. The most important risk factors for VTE are age of 75 or more, body mass index 35 or more, prior VTE or VTE in 1st degree relative. As for urological procedure, deep venous thrombosis rates of 0.2–7.8% and pulmonary embolism of 0.2–7% have been reported. It was shown that recommendations for VTE prophylaxis varies in different guidelines and their summary for most popular operations were described. Generally, most recommendations state that low-risk procedures need no prophylaxis or solely mechanical prophylaxis. Moderate-risk categories can either have mechanical or pharmacological prophylaxis. The high-risk category should have both mechanical and pharmacological prophylaxis, and extended prophylaxis should be considered. Despite massive evidences about risk of VTE among different types of surgical patients, real clinical practice doesn’t show the strict adherence to VTE prophylaxis recommendations.

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Venous thromboprophylaxis in urological cancer surgery

Cited by 4 publications

References 40 publications

Effect of RARC-ERAS nursing program on clinical outcomes in patients undergoing RARC surgery: a retrospective, propensity matching study

Effect of RARC-ERAS nursing program on clinical outcomes in patients undergoing RARC surgery: a retrospective, propensity matching study

Correlation between type of surgery and incidence of postoperative venous thromboembolism (VTE)

Thromboprophylaxis in Urological and Andrological Surgery (Review article)

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