Surgical thromboprophylaxis in daily urologic surgery: Beyond bridge therapy
| Autor: | A. García Cortés, F. Diez-Caballero Alonso, L.E. Tamariz Amador, D. Rosell Costa, M. Torres Roca, G. Andrés Boville, B. Miñana López, C. Gutiérrez Castañé, F.J. Ancizu Marckert, J.I. Pascual Piédrola, P. Doménech López, F. Villacampa Aubá, J.A. Páramo Fernández, J.E. Robles García, S. Chiva San Román, F.R. de Fata Chillón |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Anticoagulant drug business.industry medicine.medical_treatment 030232 urology & nephrology General Medicine Perioperative Bed rest Thromboembolic prophylaxis Clinical Practice 03 medical and health sciences 0302 clinical medicine Medicine Urologic surgery Robotic surgery business Intensive care medicine Surgical patients |
| Zdroj: | Actas Urológicas Españolas (English Edition). 43:455-466 |
| ISSN: | 2173-5786 |
| DOI: | 10.1016/j.acuroe.2019.05.008 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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