Efficacy and Safety of Enoxaparin for Preventing Venous Thromboembolic Events following Urologic Laparoscopic Surgery

Abstract

There is a paucity of definitive evidence that supports the use of enoxaparin to prevent venous thromboembolism (VTE) after urologic laparoscopic surgery. The purpose of this study was to evaluate the efficacy and safety of postoperative subcutaneous enoxaparin injection in patients who underwent urologic laparoscopic surgery. A total of 63 patients were evaluated from June 2010 to December 2012. All patients received postoperative prophylaxis with enoxaparin (2000 IU twice daily for 5 days). None of the patients treated with enoxaparin developed symptomatic VTE, but two cases (3.2%) of pulmonary embolism were noted before initial enoxaparin administration. Statistically significant differences were observed between the prothrombin time (PT) and activated partial thromboplastin time (APTT) values and D-dimer levels obtained at baseline and on day 7 after surgery; however, the PT and APTT values did not exceed the normal range. In addition, signs of any adverse events were not encountered in any of the patients treated with enoxaparin. The use of enoxaparin immediately after a surgery may confer valuable thromboprophylaxis benefits for urologic laparoscopic surgery.

Safety of fondaparinux for prevention of postoperative venous thromboembolism in urological malignancy: A prospective randomized clinical trial

“…Cancer surgery seems to have at least twice the risk of postoperative DVT, and more than threefold the risk of fatal PTE than similar procedures in non‐cancer patients . The incidence of VTE thus remains an issue, despite mechanical and pharmacological thromboprophylaxis, ranging from 0.5% to 7.2% after radical prostatectomy, 4.3% to 24% after radical cystectomy, 1.0% to 7.1% after nephrectomy and 0% to 11.1% after nephroureterectomy …”

“…4 The incidence of VTE thus remains an issue, despite mechanical and pharmacological thromboprophylaxis, ranging from 0.5% to 7.2% after radical prostatectomy, 5,6 4.3% to 24% after radical cystectomy, 5,7 1.0% to 7.1% after nephrectomy 5,8 and 0% to 11.1% after nephroureterectomy. 9,10 The use of heparin as thromboprophylaxis has been extensively investigated over the past 30 years. [11][12][13] The ACCP and the AUA recommend the use of LDUH (grade 1B) or LMWH (grade 1B) plus mechanical prophylaxis after general or abdominal-pelvic surgery in high-risk cancer patients.…”

The perioperative management of anticoagulants and antiplatelet agents in cervical and adrenal surgery

“…By laparotomy: No specific recommendations were made for thrombo-prophylaxis in adrenal surgery. Thus, to give the indication, the search for known individual thromboembolic risk factors such as obesity, thromboembolic history, cancer, female sex, advanced age, prolonged duration of intervention, varicose veins, can help us [5]. According to the recommendations of SFAR 2005, and by analogy with open or endo-urological surgery of the upper urinary tract, adrenal surgery is considered to be a low thrombotic surgical risk and does not require specific thrombo-prophylaxis.…”