Evaluation of the Effectiveness of Venous Thromboembolism Prophylaxis in Patients Undergoing Major Urological Surgery

Year 2024, Volume: 13 Issue: 3, 490 - 496, 25.12.2024

Pınar Ongün , Sakir Ongun

https://doi.org/10.53424/balikesirsbd.1468790

Abstract

Objective: To evaluate the effectiveness of venous thromboembolism prophylaxis in patients undergoing majör urologic surgery. Materials and Methods: Data of patients who underwent major urological surgery between January 2018 and October 2023 were analyzed. Intraoperative age, body mass index, and comorbidities were recorded. All patients received prophylaxis with low molecular weight heparin and graduated compression stockings starting in the preoperative period until mobilization in the postoperative period. The patients' historical data were reviewed, and the development of venous thromboembolism in the one-month postoperative period was investigated. Results: Nephrectomy was performed in 156 patients (45.2%), radical prostatectomy in 142 patients (41.2%), partial nephrectomy in 28 patients (8.1%), and radical cystectomy in 19 patients (5.5%). The mean age at the time of operation was 66.06±9.43 years, and the body mass index was 27.06±4.22. Hypertension was found in 51.6%, diabetes mellitus in 26.1%, coronary artery disease in 13.9%, chronic obstructive pulmonary disease in 8.1%, atrial fibrillation in 2.1%, and valvular heart disease in 1.2%. In the postoperative period, two patients developed pulmonary embolism, and one patient developed deep vein thrombosis. One of the patients with pulmonary embolism had undergone radical prostatectomy, and the other patients had undergone radical cystectomy. There was no mortality after treatment. Conclusion: Venous thromboembolism is highly preventable when appropriate precautions and prophylaxis are taken. In our study, the incidence of pulmonary embolism and deep vein thrombosis was similar to the literature.

Keywords

Prophylaxis, Urological surgical procedures, Venous thromboembolism.

Majör Ürolojik Cerrahi Geçiren Hastalara Uygulanan Venöz Tromboemboli Profilaksisinin Etkinliğinin Değerlendirilmesi

Abstract

Amaç: Araştırmada majör ürolojik cerrahi geçiren hastalara uygulanan venöz tromboemboli profilaksisinin etkinliğinin değerlendirilmesi amaçlandı. Gereç Yöntem: Ocak 2018 ve Ekim 2023 tarihleri arasında majör ürolojik cerrahi geçiren hastaların verileri incelendi. Hastaların operasyon sırasındaki yaşları, vücut kitle indeksleri, ek hastalıklarına dair veriler kaydedildi. Tüm hastalara postoperatif dönemde mobilize olana kadar preoperatif dönemde başlanarak düşük molekül ağırlıklı heparin ve dizüstü varis çorabı ile profilaksi uygulandı. Hastaların geçmiş verileri taranarak operasyon sonrası bir aylık periyodda venöz tromboemboli gelişip gelişmediği araştırıldı. Bulgular: Hastaların 156’sına (%45,2) nefrektomi, 142’sine (%41,2) radikal prostatektomi, 28 hastaya (%8,1) parsiyel nefrektomi ve 19 hastaya (%5,5) radikal sistektomi yapıldığı saptandı. Hastaların operasyon sırasındaki yaş ortalaması 66,06 ±9,43, vücut kitle indeksleri 27,06±4,22 olarak saptandı. Ameliyat edilen hastalarda %51,6 hipertansiyon, %26,1 Diyabetes Mellitus, %13,9 Koroner arter hastalığı, %8,1 Kronik obstrüktif akciğer hastalığı, %2,1 atriyal fibrilasyon, %1,2 kalp kapak hastalığı saptandı. Postoperatif dönemde 2 hastada pulmoner emboli ve 1 hastada derin ven trombozu geliştiği saptandı, pulmoner emboli gelişen hastalardan biri radikal prostatektomi, diğer hastalar ise radikal sistektomi operasyonu geçirmişti. Tedavi sonrası hastalarda mortalite gelişmedi. Sonuç: Venöz tromboembolizm uygun önlemler alınıp profilaksi uygulandığı zaman yüksek oranda önlenebilir bir durumdur. Çalışmamızda da pulmoner emboli ve derin ven trombozu görülme sıklığı literatür ile benzer olarak saptanmıştır.

Keywords

Profilaksi, Ürolojik cerrahi işlemler, Venöz tromboembolizm.

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