Multi-institutional study of symptomatic deep venous thrombosis and pulmonary embolism in prostate cancer patients undergoing laparoscopic or robot-assisted laparoscopic radical prostatectomy Journal Article


Authors: Secin, F. P.; Jiborn, T.; Bjartell, A. S.; Fournier, G.; Salomon, L.; Abbou, C. C.; Haber, G. P.; Gill, I. S.; Crocitto, L. E.; Nelson, R. A.; Cansino Alcaide, J. R.; Martínez-Piñeiro, L.; Cohen, M. S.; Tuerk, I.; Schulman, C.; Gianduzzo, T.; Eden, C.; Baumgartner, R.; Smith, J. A.; Entezari, K.; Van Velthoven, R.; Janetschek, G.; Serio, A. M.; Vickers, A. J.; Touijer, K.; Guillonneau, B.
Article Title: Multi-institutional study of symptomatic deep venous thrombosis and pulmonary embolism in prostate cancer patients undergoing laparoscopic or robot-assisted laparoscopic radical prostatectomy
Abstract: Objectives: The true incidence of symptomatic deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing laparoscopic radical prostatectomy is unknown. Our aim was to determine the incidence of symptomatic DVT and PE and the risk factors for these complications. Methods: Fourteen surgeons from 13 referral institutions from both Europe and the United States provided retrospective data for all 5951 patients treated with laparoscopic radical prostatectomy (LRP), with or without robotic assistance, since the start of their institution's experience. Symptomatic DVT and PE within 90 d of surgery were regarded as venous thromboembolism (VTE). DVT was diagnosed mostly by Doppler ultrasound or contrast venography and PE by lung ventilation/perfusion scan or chest computed tomography or both. Statistical analysis included evaluation of incidence of symptomatic DVT and PE and risk factors as determined by exact methods and logistic regression. Results: Of 5951 patients in the study, 31 developed symptomatic VTE (0.5%; 95% confidence interval [CI], 0.4%, 0.7%). Among patients with an event, 22 (71%) had DVT only, 4 had PE without identified DVT, and 5 had both. Two patients died of PE. Prior DVT (odds ratio [OR] = 13.5; 95%CI, 1.4, 61.3), current tobacco smoking (OR = 2.8; 95%CI, 1.0, 7.3), larger prostate volume (OR = 1.18; 95%CI, 1.09, 1.28), patient re-exploration (OR = 20.6; 95%CI, 6.6, 54.0), longer operative time (OR = 1.05; 95%CI, 1.02, 1.09), and longer hospital stay (OR = 1.05; 95%CI, 1.01, 1.09) were associated with VTE in univariate analysis. Neoadjuvant therapy, body mass index, surgical experience, surgical approach, pathologic stage, perioperative transfusion, and heparin administration were not significant predictors. Conclusions: The incidence of symptomatic VTE after LRP is low. These data do not support the administration of prophylactic heparin to all patients undergoing LRP, especially those without risk factors for VTE. © 2007 European Association of Urology.
Keywords: retrospective studies; major clinical study; united states; follow-up studies; laparoscopy; laparoscopic surgery; computer assisted tomography; incidence; risk factors; tomography, x-ray computed; deep vein thrombosis; doppler echography; retrospective study; risk factor; risk assessment; prostate cancer; lung embolism; postoperative complication; postoperative complications; pulmonary embolism; europe; prostatic neoplasms; prostatectomy; surgical risk; radical prostatectomy; robotics; logistic regression analysis; ultrasonography, doppler; venous thromboembolism; complication; phlebography; venous thrombosis; heparinization; lung scintiscanning
Journal Title: European Urology
Volume: 53
Issue: 1
ISSN: 0302-2838
Publisher: Elsevier Science, Inc.  
Date Published: 2008-01-01
Start Page: 134
End Page: 145
Language: English
DOI: 10.1016/j.eururo.2007.05.028
PUBMED: 17597288
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 24" - "Export Date: 17 November 2011" - "CODEN: EUURA" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Fernando Pablo Secin
    54 Secin
  2. Abdelkrim Karim Touijer
    195 Touijer
  3. Andrew J Vickers
    579 Vickers
  4. Angel M Cronin
    145 Cronin