Venous thromboprophylaxis in urological cancer surgery

Med Oncol. 2019 Nov 25;37(1):11. doi: 10.1007/s12032-019-1331-8.

Abstract

Venous thromboembolism (VTE) represents a major complication of cancer and its treatment, contributing to increased morbidity and mortality. The appropriate choice of thromboprophylaxis method and duration is, therefore, of utmost importance. We conducted an extensive review of the literature concerning VTE in patients undergoing surgery for urological cancers. Special attention was paid to risk factors, different types of surgery (transurethral, pelvic, abdominal-open, laparoscopic and robot-assisted) and different medications used (heparins, vitamin K antagonists and new oral anticoagulants). Original papers, reviews and guidelines were identified in Medline database. The available data were then summarised for the purpose of this article. Venous thromboprophylaxis is obligatory in urological cancer patients undergoing surgical treatment. Unless individual contraindications are recognised, the available guidelines should be followed. The variety of clinical scenarios and patients' comorbidities necessitate cooperation with other specialists (cardiologists, neurologists, etc.) in choosing the optimal management. Thrombosis risk must be carefully weighed against bleeding risk.

Keywords: Deep venous thrombosis; Pulmonary embolism; Thromboprophylaxis; Urological surgery; Venous thromboembolism.

Publication types

  • Review

MeSH terms

  • Anticoagulants / adverse effects
  • Anticoagulants / therapeutic use
  • Humans
  • Postoperative Complications* / drug therapy
  • Postoperative Complications* / prevention & control
  • Urologic Neoplasms / surgery*
  • Urologic Surgical Procedures / adverse effects
  • Venous Thromboembolism* / drug therapy
  • Venous Thromboembolism* / prevention & control

Substances

  • Anticoagulants