Low Risk of Venous Thromboembolism After Robot-assisted Radical Prostatectomy Through Systemic Image Assessment: A Prospective Study

Abstract

Background/Aim: The aim of the study was to evaluate the risk of venous thromboembolism (VTE) after robot-assisted radical prostatectomy (RARP) and discuss whether a uniform prophylaxis for VTE after radical prostatectomy is also suitable for robotic surgery. On this context, we investigated the incidence and risk factors of VTE, including asymptomatic events, after RARP compared to transurethral resection of bladder tumor (TUR-BT). Patients and Methods: The participants were 209 patients with localized prostate cancer who underwent RARP, and 93 patients who underwent TUR-BT as controls. The incidence and risk factors of VTE, including deep vein thrombosis and pulmonary embolism, were systemically investigated seven days after surgery using contrast-enhanced computed tomography. Results: Of the 209 RARP patients, 5.7% (12/209) patients had VTE. All events were asymptomatic and the incidence of VTE was not significantly different between the two surgeries (p=0.90). In multivariate analyses, neoadjuvant androgen deprivation therapy (ADT) (p=0.006), D-dimer value on postoperative day 1 (p=0.001) and lymphocele formation (p=0.043) were significantly associated with VTE after RARP. Conclusion: The risk of VTE after RARP might not be so high and uniform prophylaxis might not be suitable for RARP because it might be the same as that after transurethral resection for bladder tumors. However, neoadjuvant ADT, high D-dimer levels after surgery and lymphocele formation should be noted as risk factors of VTE after RARP.

Thromboembolic complications in urogenital cancers: incidence, risk factors and prevention

“…В другом исследовании показано, что факторами риска ВТЭ после роботизированной радикальной простатэктомии по поводу РПЖ являются неоадъювантная андрогенная депривация, высокие уровни D-димера после операции и формирование лимфоцеле. В данной работе среди 209 пациентов, перенесших роботизированную радикальную простатэктомию, в 5,7 % случаев выявлена ВТЭ [35].…”