Abstract：
OBJECTIVE: Postoperative pulmonary embolism is a leading cause of mortality in patients undergoing major urologic surgeries, presenting a complex challenge in balancing the risks of venous thromboembolism (VTE) and perioperative bleeding. This study examines the current evidence on thromboprophylaxis in urological procedures, focusing on procedure-specific considerations.
METHODS: Literature on thromboprophylaxis in urological procedures was reviewed during the past decade.
RESULTS: Various mechanical thromboprophylaxis methods, such as compression stockings, pneumatic compression devices, foot pumps, mobilization, and exercises, are available preventive measures. Additionally, unfractionated heparin (UFH) and low molecular weight heparin (LMWH) are commonly used pharmacological agents for VTE prevention, with the choice between mechanical, pharmacological, or combined approaches tailored to individual patient characteristics and surgical requirements. Patient risk stratification into low, medium, and highrisk categories based on age, BMI, and VTE history guides the selection of thromboprophylaxis strategies. Surgical procedures are categorized as oncological or non-oncological, with uro-oncological surgeries posing a higher VTE risk than non-oncological procedures. Consequently, a combination of pharmacological and mechanical prophylaxis is typically recommended for uro-oncological patients, while pharmacological prophylaxis is reserved for high-risk individuals undergoing non-oncological surgeries. Mechanical prophylaxis is advised for high-risk patients undergoing procedures with elevated VTE risk.
CONCLUSIONS: This study summarized an optimal thromboprophylaxis protocol taking into account patient risk factors and the specific urological procedure.
METHODS: Literature on thromboprophylaxis in urological procedures was reviewed during the past decade.
RESULTS: Various mechanical thromboprophylaxis methods, such as compression stockings, pneumatic compression devices, foot pumps, mobilization, and exercises, are available preventive measures. Additionally, unfractionated heparin (UFH) and low molecular weight heparin (LMWH) are commonly used pharmacological agents for VTE prevention, with the choice between mechanical, pharmacological, or combined approaches tailored to individual patient characteristics and surgical requirements. Patient risk stratification into low, medium, and highrisk categories based on age, BMI, and VTE history guides the selection of thromboprophylaxis strategies. Surgical procedures are categorized as oncological or non-oncological, with uro-oncological surgeries posing a higher VTE risk than non-oncological procedures. Consequently, a combination of pharmacological and mechanical prophylaxis is typically recommended for uro-oncological patients, while pharmacological prophylaxis is reserved for high-risk individuals undergoing non-oncological surgeries. Mechanical prophylaxis is advised for high-risk patients undergoing procedures with elevated VTE risk.
CONCLUSIONS: This study summarized an optimal thromboprophylaxis protocol taking into account patient risk factors and the specific urological procedure.
摘要：
静脉血栓栓塞症(VTE),其中包括深静脉血栓形成（DVT）和肺栓塞（PE），是泌尿外科手术后可能发生的严重并发症。它是手术患者中可预防的医院相关发病率和死亡率的主要原因[1]。在泌尿外科手术中，VTE仍然是严重的并发症和重大挑战[2]，PE被认为是泌尿外科大手术患者术后死亡的最常见原因[3]。在泌尿外科手术中使用血栓预防的决定涉及权衡VTE风险的降低与围手术期出血的潜在增加[4]。然而,在泌尿外科手术中缺乏预防血栓的手术特异性证据。因此,我们回顾了泌尿外科手术中血栓预防的现有证据,并尝试在特定手术背景下总结这些证据.
