Thromboembolic disease after renal surgery

UroToday – Perioperative Clinical Thromboembolic Events after Radical or Partial Nephrectomy

This study demonstrates that while the incidence of thromboembolic phenomena is low in patients undergoing renal surgery, there are specific subsets of patients that can be identified that are at increased risk and therefore deserving of more aggressive prophylaxis. These include older patients, those with a history of cardiac disease, those with a history of prior DVT, and those who have increased blood loss at the time of surgery. Prophylactic anticoagulation might be considered in addition to pneumatic compression groups in these specific subpopulations.

There has been a recent increased attention to DVT and PE in surgical patients.
There are no definite recommendations for urologic patients. We all agree that compression devices are necessary, but the risks and benefits of perioperative anticoagulation are not clear. With partial nephrectomies there is a tendency to have bleeding during and after surgery, so providing blood thinners will likely reduce the risk of complications from clotting, but may lead to increased bleeding.
I would be more likely to give anticoaguulation for patients undergoing a total nephrectomy as opposed to a partial nephrectomy.
Studies like this are important and need to be continued.