1641 Rates of Venous Thromboembolism (Vte) in Patients Undergoing Robotic Prostatectomy: A Single Institution Comparison Between Two Surgeons Using Fractionated Heparin/Sequential Compression Devices (Scds) vs. SCDS Alone

You have accessJournal of UrologyProstate Cancer: Localized1 Apr 20111641 RATES OF VENOUS THROMBOEMBOLISM (VTE) IN PATIENTS UNDERGOING ROBOTIC PROSTATECTOMY: A SINGLE INSTITUTION COMPARISON BETWEEN TWO SURGEONS USING FRACTIONATED HEPARIN/SEQUENTIAL COMPRESSION DEVICES (SCDS) VS. SCDS ALONE Kristen R. Scarpato, David Chalmers, Ilene Staff, Alison Champagne, Joseph Tortora, Joseph R. Wagner, and Stuart S. Kesler Kristen R. ScarpatoKristen R. Scarpato Farmington, CT More articles by this author , David ChalmersDavid Chalmers Farmington, CT More articles by this author , Ilene StaffIlene Staff Hartford, CT More articles by this author , Alison ChampagneAlison Champagne Hartford, CT More articles by this author , Joseph TortoraJoseph Tortora Hartford, CT More articles by this author , Joseph R. WagnerJoseph R. Wagner Hartford, CT More articles by this author , and Stuart S. KeslerStuart S. Kesler Hartford, CT More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1750AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Venous thromboembolism is a major complication of urologic surgery. Data is limited regarding the benefits of using heparin prophylaxis in patients undergoing minimally invasive urologic surgery. The 2008 AUA Best Practice Statement recommends SCDs for urologic laparoscopic and robotically assisted procedures but provides no clear recommendations for the usage of pharmacologic prophylaxis. We compare the rates of post-operative VTE in two groups of patients operated on by two surgeons; one who consistently used heparin with SCDs (Group 1) and the other who used SCDs alone (Group 2) for prophylaxis. METHODS An IRB approved prospectively managed database was analyzed. Group 1 received SCDs just prior to induction and 5,000 units of heparin subcutaneously just after induction. SCDs continued postoperatively and heparin was given twice a day until discharge. Group 2 maintained SCDs until ambulatory. VTE rate, patient age, BMI, operative time, lymphocele rate, estimated blood loss, and pathologic stage were compared between the two groups. Categorical variables were analyzed with chi square test of proportions and continuous variables with t-test using SPSS v 14 software. RESULTS 1,035 consecutive patients underwent robotic prostatectomy between August 1, 2007 and September 30, 2010. 652 patients received heparin/SCDs and 383 received SCDs alone. Patient age, BMI, estimated blood loss, and pathologic stage were the same in the two groups. There was one lymphocele in each group. Although operative times were longer in Group 2 (228.0 v 165.4 min, p<0.001), the incidence of VTE was the same (0.8% v 0.8%, p=.620). BMI, operative time, EBL, and the performance of lymph node dissection were not associated with VTE. CONCLUSIONS The risk of VTE in patients undergoing robotic prostatectomy is low and not significantly reduced with the administration of prophylactic heparin/SCDs compared to SCDs alone. Group 1 (Heparin/SCDs) Group 2 (SCDs alone) P-value % Lymph Node Dissection 60.6% 42.8% Age (mean+/-std dev) 59.7+/-6.5 59.2+/-6.2 0.236 BMI (mean+/-std dev) 28.2+/-3.9 28.1+/-4.0 0.979 Operative Time [mins] (mean+/-std dev) 165.4+/-34.7 228.0+/-40.5 EBL [cc] (mean+/-std dev) 247.0+/-186.3 230.4+/-147.9 0.136 VTE 5(0.8%) 3(0.8%) 0.62 VTE No VTE P-value +LND/-LND 1.3%/0.2% 98.7%/99.8% 0.056 BMI (mean+/-std dev) 29.3+/-5.5 28.1+/-4.0 0.402 Operative Time [mins] (mean+/-std dev) 211.3+/-45.9 188.3+/-47.7 0.176 EBL [cc] (mean+/-std dev) 287.5+/-148.2 240.5+/-173.4 0.445 © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e658-e659 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kristen R. Scarpato Farmington, CT More articles by this author David Chalmers Farmington, CT More articles by this author Ilene Staff Hartford, CT More articles by this author Alison Champagne Hartford, CT More articles by this author Joseph Tortora Hartford, CT More articles by this author Joseph R. Wagner Hartford, CT More articles by this author Stuart S. Kesler Hartford, CT More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...