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• W1992701406 abstract "You have accessJournal of UrologyKidney Cancer: Localized (III)1 Apr 20131451 PROSPECTIVE OBSERVATIONAL STUDY OF VENOUS THROMBOEMBOLISM RISK OF PATIENTS UNDERGOING PARTIAL AND RADICAL NEPHRECTOMY Jessica T. Casey, Gregory B. Auffenberg, Laura Mazzenga, Theresa Sweeney, Michael A. Dixon, Chris M. Gonzalez, and William J. Catalona Jessica T. CaseyJessica T. Casey Chicago, IL More articles by this author , Gregory B. AuffenbergGregory B. Auffenberg Chicago, IL More articles by this author , Laura MazzengaLaura Mazzenga Chicago, IL More articles by this author , Theresa SweeneyTheresa Sweeney Chicago, IL More articles by this author , Michael A. DixonMichael A. Dixon Chicago, IL More articles by this author , Chris M. GonzalezChris M. Gonzalez Chicago, IL More articles by this author , and William J. CatalonaWilliam J. Catalona Chicago, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2805AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Given the risk of bleeding after partial nephrectomy, there is a hesitation to use perioperative pharmacological prophylaxis. We present the contemporary risk of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), after renal surgery. METHODS We enrolled patients undergoing partial and radical nephrectomy to a prospective observational study with the primary outcome measure of VTE events. The study was approved by our IRB, and baseline demographic data was collected at time of consent. The timing and type of perioperative prophylaxis (including pharmacologic prophylaxis, sequential compression devices (SCD) and thromboembolic deterrent stockings (TED)) was left to the discretion of the operating surgeons. In order to capture all events including post-hospital-discharge events, participants were contacted by phone at least 6 weeks postoperatively and interviewed about undergoing evaluation for or being diagnosed with a clinically significant VTE. Retrospective chart review was performed for patients who were not reachable. RESULTS Between April 2011 and October 2012, 94 patients were enrolled: 22 (23.4%) open radical nephrectomy, 31 (33.0%) laparoscopic radical nephrectomy, 20 (21.3%) open partial nephrectomy, and 21 (22.3%) robotic partial nephrectomy. Patient data in regard to mechanical and pharmacologic VTE prophylactic measures and VTE rates across all procedures are shown in the Table. Three patients (3.2%) were diagnosed with a VTE; all 3 received postoperative pharmacologic prophylaxis prior to the VTE (mean 16 hours postoperatively). On multivariate analysis the rate of VTE was not significantly affected by patient age, sex (all three were female, no statistically significant difference), length of surgery, partial vs. radical nephrectomy, open vs. minimally invasive approach, and benign vs. malignant pathology. CONCLUSIONS In a prospective, non-randomized study, we observed a low overall risk (3.2%) of VTE after partial and radical nephrectomy. In this cohort, with limited statistical power to rule out a possible benefit, the use of pharmacologic VTE prophylaxis did not significantly modify VTE risk. Patient enrollment is ongoing to further enhance the power of this study. Open Radical Nephrectomy Laparoscopic Radical Nephrectomy Open Partial Nephrectomy Robotic Partial Nephrectomy Total Total, n 22 31 20 21 94 Preoperative pharmacologic prophylaxis, % 13.6% 3.2% 0.0% 0.0% 4.3% Postoperative pharmacologic prophylaxis, % 77.3% 74.2% 45.0% 9.5% 59.6% Perioperative TED, % 54.5% 35.5% 55.0% 9.5% 38.3% Perioperative SCD, % 100.0% 100.0% 100.0% 100.0% 100.0% Mean time to first ambulation, hours 32.8 15.8 24.4 14.5 21.1 VTE events, n (%) 0 (0%) 1 (3.2%) 2 (10.0%) 0 (0%) 3 (3.2%) © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e595 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Metrics Author Information Jessica T. Casey Chicago, IL More articles by this author Gregory B. Auffenberg Chicago, IL More articles by this author Laura Mazzenga Chicago, IL More articles by this author Theresa Sweeney Chicago, IL More articles by this author Michael A. Dixon Chicago, IL More articles by this author Chris M. Gonzalez Chicago, IL More articles by this author William J. Catalona Chicago, IL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W1992701406 title "1451 PROSPECTIVE OBSERVATIONAL STUDY OF VENOUS THROMBOEMBOLISM RISK OF PATIENTS UNDERGOING PARTIAL AND RADICAL NEPHRECTOMY" @default.
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