Low molecular weight heparin and radical prostatectomy: a
prospective analysis of safety and side effects

Mo, Koch; Ja, Smith

doi:10.1038/sj.pcan.4500214

Cited by 47 publications

(22 citation statements)

References 11 publications

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“…1 LDUH and LMWH are efficacious in patients undergoing urologic surgery. 1,18,19 In these patients, the use of intermittent pneumatic compression or graduated elastic stockings is likely to be effective as well. The combination of mechanical and pharmacological prophylaxis may be more effective than either modality alone.…”

Section: Urologic Surgerymentioning

confidence: 99%

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Prevention of Venous Thromboembolism in Surgical Patients

2004

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Abstract-Venous thromboembolism (VTE) is a common complication of surgical procedures. The risk for VTE in surgical patients is determined by the combination of individual predisposing factors and the specific type of surgery. Prophylaxis with mechanical and pharmacological methods has been shown to be effective and safe in most types of surgery and should be routinely implemented. For patients undergoing general, gynecologic, vascular, and major urologic surgery, low-dose unfractionated heparin or low-molecular-weight heparin (LMWH) are the options of choice. For low-risk urologic surgery, early postoperative mobilization of patients is the only intervention warranted. For higher-risk patients, including those undergoing elective hip or knee replacement and surgery for hip fracture, vitamin K antagonists, LMWH, or fondaparinux are recommended. For patients undergoing neurosurgery, graduated elastic stockings are effective and safe and may be combined with LMWH to further reduce the risk of VTE. The role of prophylaxis is less defined in patients undergoing elective spine surgery, as well as laparoscopic and arthroscopic surgery. A number of issues related to prophylaxis of VTE after surgery deserve further clarification, including the role of screening for asymptomatic deep vein thrombosis, the best timing for initiation of pharmacological prophylaxis, and the optimal duration of prophylaxis in high-risk patients. Key Words: venous thromboembolism Ⅲ deep vein thrombosis Ⅲ pulmonary embolism Ⅲ heparin Ⅲ low-molecular-weight heparin Ⅲ vitamin K antagonists

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Section: Urologic Surgerymentioning

confidence: 99%

“…The combination of mechanical and pharmacological prophylaxis may be more effective than either modality alone. 19 Most data concerning VTE in urologic surgery has been obtained from patients undergoing prostatectomy. The risk of VTE seems to be low in patients undergoing transurethral prostatectomy.…”

Section: Urologic Surgerymentioning

confidence: 99%

Prevention of Venous Thromboembolism in Surgical Patients

2004

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“…Within 3-7 days of thromboembolism prophylaxis, there was no symptomatic VTE episode diagnosed and at the same time, no excessive bleeding was observed [232]. Koch assessed the effectiveness of enoxaparin administered an hour before surgery at the dose of 30 mg (and next after 12 hours) in patients undergoing open prostatectomy and did not report symptomatic VTE events in the group receiving prophylaxis, whereas 3.3% in the controls, who used only compression means, presented with thromboembolic events [233]. In this study, postoperative bleedings (7.8% vs. 0%) and lymph collection in the pelvis were diagnosed more often in patients receiving pharmacological prevention [233].…”

Section: Venous Thromboembolism Prophylaxis In Cancer Patientsmentioning

confidence: 99%

“…Koch assessed the effectiveness of enoxaparin administered an hour before surgery at the dose of 30 mg (and next after 12 hours) in patients undergoing open prostatectomy and did not report symptomatic VTE events in the group receiving prophylaxis, whereas 3.3% in the controls, who used only compression means, presented with thromboembolic events [233]. In this study, postoperative bleedings (7.8% vs. 0%) and lymph collection in the pelvis were diagnosed more often in patients receiving pharmacological prevention [233]. Information on potential influence of pharmacological prophylaxis on incidence of lymph collection after pelvic lymphadenectomy is also available in the other studies [234][235][236][237].…”

Section: Venous Thromboembolism Prophylaxis In Cancer Patientsmentioning

confidence: 99%

Venous thromboembolism prophylaxis in cancer patients — guidelines focus on surgical patients

Urbanek¹,

Krasiński

Kostrubiec

et al. 2017

Acta Angiologica

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“…13 More importantly, when mechanical and pharmacologic strategies are combined, they may have synergistic effects. [14][15][16] High-risk patients should be considered for combination methods.…”

Section: Guidelines and Performance Measures For The Prevention And Tmentioning

confidence: 99%

Guidelines and Performance Measures for the Prevention and Treatment of Venous Thromboembolism

Umland

2008

JMCP

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1 Most cases are asymptomatic; however, in approximately 600,000 cases, the thrombus embolizes and travels to the right atrium, through the right ventricle, and into the pulmonary arterial tree, lodging in the pulmonary vasculature. The mortality rate in patients with pulmonary embolism (PE) is high (approximately 10%), with nearly 60,000 deaths attributed to PE annually in the United States. Patients who survive PE may develop chronic pulmonary hypertension due to damage to the pulmonary vasculature. DVT can cause permanent damage to the valves of the venous system and may also result in post-thrombotic syndrome; chronic inflammation, edema, and pain; and, in severe cases, venous stasis ulcers of the lower extremities. ■■ PrevalenceVenous thromboembolism (VTE) risk factors are common among hospitalized patients. Using criteria established by the American College of Chest Physicians (ACCP) in their evidence-based guidelines for the prevention of VTE, review of a U.S. database containing more than 38 million inpatient discharge records showed that more than 12 million (31%) patients met the ACCP criteria for prophylaxis: 4.3 million surgical and 7.7 million medical patients.2,3 The larger number of medical patients at risk for VTE is significant because, although VTE risk is well recognized in surgical patients, the danger for medical patients is frequently underappreciated.While VTE is often considered to be a condition that develops primarily in elderly, bedridden hospital patients, recent medical record analysis provides a different picture. 4 A review of 1,897 VTE sufferers from Worcester, Massachusetts, showed that 74% of these patients developed VTE signs and symptoms as outpatients. The mean age of those 1,399 outpatients who developed VTE was 63 years, and 33% were aged < 55 years. In contrast, the mean age of the 498 inpatients who developed VTE was 67 years, with only 21% aged < 55 years. The presence of 5 VTE risk factors (recent hospitalization, recent surgery, active malignant neoplasm, recent infection, history of VTE) was ascertained in outpatients who developed VTE: 30% had no risk factors, 32% had 1, and 34% had 2-3. For patients who experienced VTE within 3 months after hospitalization (with or without surgery), two thirds experienced VTE within 1 month. The median and mean length of stay for this initial hospitalization was 4.0 and 7.4 days, respectively. It appears that an increased risk for VTE is present in the early post-discharge period after brief hospital stays for both medical and surgical patients.The risk of DVT without prophylaxis is 10%-20% in medical patients, 10%-80% for critical care patients, 20%-50% in patients ABSTRACT BACKGROUND: Venous thromboembolism (VTE) is a common and often preventable cause of morbidity and mortality in the United States, with a widespread economic impact.

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Low molecular weight heparin and radical prostatectomy: a prospective analysis of safety and side effects

Cited by 47 publications

References 11 publications

Prevention of Venous Thromboembolism in Surgical Patients

Prevention of Venous Thromboembolism in Surgical Patients

Venous thromboembolism prophylaxis in cancer patients — guidelines focus on surgical patients

Guidelines and Performance Measures for the Prevention and Treatment of Venous Thromboembolism

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