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• W2045577237 abstract "You have accessJournal of UrologyProstate Cancer: Localized VII1 Apr 20101752 PREVENTING THROMBOEMBOLIC COMPLICATIONS AFTER RADICAL RETROPUBIC PROSTATECTOMY WITH COMPRESSION STOCKINGS AND AMBULATION ONLY Jessica T. Casey, Ronald J. Kim, Matthias D. Hofer, Brian T. Helfand, Stacy Loeb, Norm D. Smith, and William J. Catalona Jessica T. CaseyJessica T. Casey More articles by this author , Ronald J. KimRonald J. Kim More articles by this author , Matthias D. HoferMatthias D. Hofer More articles by this author , Brian T. HelfandBrian T. Helfand More articles by this author , Stacy LoebStacy Loeb More articles by this author , Norm D. SmithNorm D. Smith More articles by this author , and William J. CatalonaWilliam J. Catalona More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1601AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Despite the American College of Chest Physicians' recommendation of routine thromboembolic prophylaxis with low-dose unfractionated heparin during open urologic surgery, there is no consensus on its use for open radical retropubic prostatectomy (RRP). Prior studies have suggested that venous thromboembolism (VTE) occurs in 0.2% to 3.6% of patients undergoing RRP. In the absence of a randomized trial or cohort study, we retrospectively reviewed the incidence of clinically evident VTE in a contemporary RRP series. METHODS From 2003-2009, 1471 men underwent RRP by a single surgeon. Clinical characteristics and outcomes were recorded in a prospective database. Our primary endpoint was clinical VTE, such as deep vein thrombosis (DVT) or pulmonary embolus (PE). Our method of prophylaxis consisted of thromboembolic deterrent stockings (TEDs) with early and frequent ambulation for the majority of patients. Patients who were considered “high-risk” by virtue of a prior history of DVT or PE were additionally treated with sequential compression devices (SCDs), as well as intraoperative and postoperative low-dose heparin. RESULTS 99% of procedures required minimal prophylaxis with TEDs and early ambulation, while 1% were considered high-risk and required SCDs and low-dose heparin. All VTE occurred in low-risk patients. 8 (0.5%) patients had a clinically evident DVT, and 3 (0.2%) had a PE, yielding an overall frequency of 0.7%. There was no association between VTE and patient demographics. No patient who received heparin had clinical evidence of lymphocele formation. There were also no fatal thromboembolic complications in this series. CONCLUSIONS In our series, a prophylactic strategy involving TEDs and early ambulation was successful for the prevention of VTE in the great majority of patients undergoing RRP. In patients with a history of VTE, no clinically evident thromboembolic events occurred with the addition of SCDs and mini-dose heparin. Unlike other major surgical procedures for the treatment of malignancy, the rate of VTE following RRP is exceedingly low, suggesting that a less aggressive prophylactic strategy yields acceptable outcomes. Chicago, IL© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e677 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jessica T. Casey More articles by this author Ronald J. Kim More articles by this author Matthias D. Hofer More articles by this author Brian T. Helfand More articles by this author Stacy Loeb More articles by this author Norm D. Smith More articles by this author William J. Catalona More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2045577237 title "1752 PREVENTING THROMBOEMBOLIC COMPLICATIONS AFTER RADICAL RETROPUBIC PROSTATECTOMY WITH COMPRESSION STOCKINGS AND AMBULATION ONLY" @default.
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