Mp22-11 Thromboembolic Events After Robotic Radical Cystectomy: A Comparative Analysis of Extended and Limited Prophylaxis

You have accessJournal of UrologyBladder Cancer: Invasive II (MP22)1 May 2024MP22-11 THROMBOEMBOLIC EVENTS AFTER ROBOTIC RADICAL CYSTECTOMY: A COMPARATIVE ANALYSIS OF EXTENDED AND LIMITED PROPHYLAXIS Jordan M. Rich, Jack Geduldig, Yuval Elkun, Neeraja Tillu, Reuben Ben-David, Etienne Lavallee, Kyrollis Attalla, Reza Mehrazin, Peter Wiklund, and John P. Sfakianos Jordan M. RichJordan M. Rich , Jack GeduldigJack Geduldig , Yuval ElkunYuval Elkun , Neeraja TilluNeeraja Tillu , Reuben Ben-DavidReuben Ben-David , Etienne LavalleeEtienne Lavallee , Kyrollis AttallaKyrollis Attalla , Reza MehrazinReza Mehrazin , Peter WiklundPeter Wiklund , and John P. SfakianosJohn P. Sfakianos View All Author Informationhttps://doi.org/10.1097/01.JU.0001008608.50694.4b.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is little consensus on postoperative venous thromboembolism (VTE) prophylaxis regimens after robot-assisted radical cystectomy (RARC) with data mostly extrapolated from other cancers. We aim to compare limited (only inpatient) VTE prophylaxis after RARC to limited plus extended prophylaxis. METHODS: This is a retrospective review of all RARC patients at our center between 2014-2022, identifying two groups: patients after a prospectively implemented protocol (January 2018 to present) utilizing a prolonged 21-day postoperative course of either enoxaparin 40mg daily or apixaban 2.5mg twice daily after discharge, or patients prior to January 2018 receiving only limited VTE prophylaxis during their immediate postoperative inpatient stay. Primary outcome: incidence of symptomatic VTE confirmed with imaging within 90-days postoperatively. Secondary outcomes: major hemorrhage, complications, readmission, and mortality within 30-days postoperatively. Descriptive statistics depicted baseline patient characteristics, operative information, and complications. Differences were compared between groups. Logistic regression was used to determine associations between variables and the primary outcome. RESULTS: Eighty-six patients received limited prophylaxis and 364 received extended prophylaxis (Table 1). As described in Figure 1, 12 (2.7%) patients experienced VTE within 90-days postoperatively: (10 2.7% extended vs. 2 2.3% limited, p=0.90). Upon stratification into EAU "low-risk" or "high +intermediate-risk" groups, no statistically significant difference in VTE rates was seen between the extended or limited groups. When controlling for prophylaxis regimen, intracorporeal approach was found to be predictive of a lower risk of VTE (p=0.019). CONCLUSIONS: Limited and extended prophylaxis showed no statistically significant differences in VTE rates among RARC patients. Further studies are necessary for RARC patients to improve guidelines. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e346 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Jordan M. Rich More articles by this author Jack Geduldig More articles by this author Yuval Elkun More articles by this author Neeraja Tillu More articles by this author Reuben Ben-David More articles by this author Etienne Lavallee More articles by this author Kyrollis Attalla More articles by this author Reza Mehrazin More articles by this author Peter Wiklund More articles by this author John P. Sfakianos More articles by this author Expand All Advertisement PDF downloadLoading ...