Regístrese
Buscar en
Actas Urológicas Españolas (English Edition)
Toda la web
Inicio Actas Urológicas Españolas (English Edition) Surgical thromboprophylaxis in daily urologic surgery: Beyond bridge therapy
Journal Information
Vol. 43. Issue 9.
Pages 455-466 (November 2019)
Share
Share
Download PDF
More article options
ePub
Visits
0
Vol. 43. Issue 9.
Pages 455-466 (November 2019)
Review article
DOI: 10.1016/j.acuroe.2019.05.008
Surgical thromboprophylaxis in daily urologic surgery: Beyond bridge therapy
La tromboprofilaxis quirúrgica en el día a día de la cirugía urológica: más allá de la terapia puente
Visits
0
P. Doménech Lópeza,
Corresponding author
pdomenech@unav.es

Corresponding author.
, J.E. Robles Garcíaa, C. Gutiérrez Castañéa, S. Chiva San Romána, A. García Cortésa, F.J. Ancizu Marckerta, L.E. Tamariz Amadorb, G. Andrés Bovillea, F. Villacampa Aubáa, F.R. de Fata Chillóna, F. Diez-Caballero Alonsoa, M. Torres Rocaa, D. Rosell Costaa, B. Miñana Lópeza, J.I. Pascual Piedrolaa, J.A. Páramo Fernándezb
a Departamento de Urología Clínica, Universidad de Navarra, Pamplona, Spain
b Departamento de Hematología Clínica, Universidad de Navarra, Pamplona, Spain
This item has received
0
Visits
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Tables (20)
Table 1. VTE risk staging.
Table 2. Antiplatelet drugs.
Table 3. Anticoagulant drugs.
Table 4. Recommendations in major outpatient surgery.
Table 5. Recommendations for transurethral resection.
Table 6. Recommendations in female pelvic floor surgery.
Table 7. Recommendations in radical cystectomy.
Table 8. Recommendations in open prostatectomy.
Table 9. Recommendations in laparoscopic prostatectomy.
Table 10. Recommendations in robotic prostatectomy.
Table 11. Recommendations in neurovascular preservation surgery.
Table 12. Recommendations in renal surgery.
Table 13. Recommendations in percutaneous nephrolithotomy.
Table 14. Recommendations in kidney transplant surgery.
Table 15. Acute treatment for thrombosis with low-molecular-weight heparins.
Table 16. Summary of indications according to previous treatment. Global indications.
Table 17. Global recommendations for thromboembolic prophylaxis.
Table 18. Classification of thrombosis risk according to the European guidelines.
Table 19. General recommendations for drug suspension and reintroduction according to previous therapies.
Table 20. Prophylaxis recommendations according to type of surgery. Following the European clinical guides.
Show moreShow less
Abstract
Introduction

With the advanced laparoscopic and robotic surgery, thromboembolic prophy-laxis in urologic procedures has traditionally been based on the experience of other surgicalspecialties. This paper aims to analyze the current recommendations, through a detailed studyof the European clinical guidelines and bibliography, applying the recommendations of throm-boprophylaxis to the daily urological practice.

Objectives

To elaborate general recommendations to surgical patients in Urology, avoidingthe risk of perioperative thromboembolic events. Optimize medication in chronic patients andaccurately classify who are eligible for bridge therapy.

Material and methods

A review of the available literature and the European clinical guidelineswas carried out. We analyzed the most recent consensus articles by studying the availablebibliography, trials and reviews on which the European guidelines for thromboprophylaxis inurology are based.

Results

Thromboembolic prophylaxis should be targeted towards surgeries that require abdo-minal approaches, prolonged bed rest or oncological pathologies. Bridge therapies with lowmolecular weight heparins should be limited. Patients undergoing treatment for chronic condi-tions can benefit from bridge therapies in specific cases.

Conclusions

According to the current guidelines, there might be an overuse of heparins in thedaily clinical practice. The development of -direct oral- anticoagulants have shown to reducethe time to reintroduction of medication for chronic conditions as well as a more effectivebleeding management.

Keywords:
Venous thromboembolism
Thromboprophylaxis
Postoperative hemorrhage
Risk prevention
Bridge therapy
Anti-aggregation drug
Anticoagulant drug
Palabras Clave:
Tromboemboli smovenoso
Tromboprofilaxis
Hemorragiapo squirúrgica
Prevención de riesgo
Terapia puente
Fármacoantia gregante
Fármaco anticoagulante
Resumen
Introducción

Con el avance de la cirugía laparoscópica y robótica, la profilaxis tromboembó-lica en los procedimientos urológicos se han basado clásicamente en la experiencia de otrasespecialidades quirúrgicas. En este trabajo se realiza un análisis de la actualidad de las recomen-daciones, basado en un estudio pormenorizado de las guías clínicas europeas y en la bibliografía,aplicando las recomendaciones de tromboprofilaxis a la práctica urológica diaria.

Objetivos

Elaborar unas recomendaciones generales aplicables a los pacientes quirúrgicos enurología, evitando la aparición de eventos tromboembólicos en el periodo perioperatorio. Opti-mizar la medicación y el ajuste en pacientes crónicos y conocer qué pacientes son candidatosa terapias puente.

Material y métodos

Se ha realizado una revisión de la literatura disponible y de las guías clí-nicas europeas. Se analizan los artículos de consenso más recientes realizando una revisión dela bibliografía disponible y los estudios y revisiones en los que se basan las guías europeas detromboprofilaxis en urología.

Resultados

La profilaxis tromboembólica se debe emplear en aquellas cirugías que requieranabordajes abdominales, encamamiento prolongado o enfermedades oncológicas. Las terapiaspuente con heparinas de bajo peso molecular deben ser reducidas. Los pacientes en tratamientocrónico se pueden beneficiar de terapias puente en casos concretos.

Article

These are the options to access the full texts of the publication Actas Urológicas Españolas (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Actas Urológicas Españolas (English Edition)

Comprar
Comprar acceso al artículo

Comprando el artículo el PDF del mismo podrá ser descargado

Precio 22,50 €

Comprar ahora
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

es en pt
Política de cookies Cookies policy Política de cookies
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.