Enoxaparin sodium for pharmacological prevention of postoperative venous thromboembolic complications in urological patients
- Authors: Popov S.V.1, Guseinov R.G.2, Orlov I.N.1, Sivak K.V.1, Skryabin O.N.1, Perepelitsa V.V.1, Katunin A.S.1, Yasheva S.Y.1, Zaitsev A.S.1
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Affiliations:
- Saint Petersburg GBUZ «City Hospital Saint Luka»
- Saint Petersburg State University
- Issue: No 3 (2023)
- Pages: 58-69
- Section: ORIGINAL ARTICLES
- URL: https://journal-vniispk.ru/1728-2985/article/view/258061
- DOI: https://doi.org/10.18565/urology.2023.3.58-69
- ID: 258061
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Abstract
Introduction. Currently, there are paucity of reports on the success of medical prevention of venous thromboembolic complications after urological procedures.
Aim. To evaluate the efficiency of enoxaparin sodium for prevention of postoperative venous thromboembolic complications in urological patients.
Materials and methods. According to the medical records of 151 men and women aged 22 to 92 years old who were undergone to elective surgical treatment in April 2021, the results of the thrombin generation assay and ultrasound study of the inferior vena cava were retrospectively analyzed. All patients were divided into 6 study groups depending on the degree of risk of postoperative venous thromboembolism (very low, low, moderate, high, very high and extremely high). The data obtained during the thrombin generation assay in patients from different groups were compared with those in healthy volunteers (n=30, control group) and evaluated in dynamics. In addition, intergroup comparison was done.
Results. All study participants prior to surgery had a significant increase in peak thrombin and endogenous thrombin potential (ETP) by 5-26% and 13.5-21.5%, respectively. The postoperative findings were as following: 1) one hour after the procedure, a significant (by 9-28.6%) decrease in the normal bleeding time (Lag time); 2) a significant increase in the peak thrombin by 4.8-10.6% 1 hour after surgery and by 11-40.2% at the end of the first postoperative week; 3) reducing the time to peak thrombin (ttPeak) by 13-15%; 4) increase in ETP. According to the ultrasonic data, all study participants had no signs of thrombosis of the inferior vena cava system.
Conclusion: In urological patients requiring surgical treatment, before and after procedure, there is almost always a shift in the hemostasis towards the predominance of the blood coagulation system. Under such conditions, to prevent the development of postoperative VTE, it is expedient and pathogenetically justified to use enoxaparin sodium in a single dose of 0.4 ml or 4000 anti-Xa IU administered once a day s/c 24 hours before the procedure and till full activation of a patient.
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##article.viewOnOriginalSite##About the authors
S. V. Popov
Saint Petersburg GBUZ «City Hospital Saint Luka»
Email: doc.popov@gmail.com
ORCID iD: 0000-0003-2767-7153
Ph.D., MD, Chief
Russian Federation, Saint PetersburgR. G. Guseinov
Saint Petersburg State University
Author for correspondence.
Email: rusfa@yandex.ru
ORCID iD: 0000-0001-9935-0243
SPIN-code: 4222-4601
assistant at the Department of Hospital Surgery of Medical Faculty
Russian Federation, Saint PetersburgI. N. Orlov
Saint Petersburg GBUZ «City Hospital Saint Luka»
Email: doc.orlov@gmail.com
ORCID iD: 0000-0001-5566-9789
Ph.D., Deputy head physician on medical care
Russian Federation, Saint PetersburgK. V. Sivak
Saint Petersburg GBUZ «City Hospital Saint Luka»
Email: kvsivak@gmail.com
ORCID iD: 0000-0003-4064-5033
Ph.D., researcher
Russian Federation, Saint PetersburgO. N. Skryabin
Saint Petersburg GBUZ «City Hospital Saint Luka»
Email: skryabin_55@mail.com
ORCID iD: 0000-0002-6664-2861
Ph.D., MD, professor, chief oncologist; Scientific chief
Russian Federation, Saint PetersburgV. V. Perepelitsa
Saint Petersburg GBUZ «City Hospital Saint Luka»
Email: perepelitsa_vit@mail.ru
ORCID iD: 0000-0002-7656-4473
Ph.D., urologist
Russian Federation, Saint PetersburgA. S. Katunin
Saint Petersburg GBUZ «City Hospital Saint Luka»
Email: aleksandrkatunin@gmail.com
ORCID iD: 0000-0003-3676-6246
urologist
Russian Federation, Saint PetersburgS. Yu. Yasheva
Saint Petersburg GBUZ «City Hospital Saint Luka»
Email: yashevasofi@mail.ru
ORCID iD: 0000-0001-7918-3580
urologist
Russian Federation, Saint PetersburgA. S. Zaitsev
Saint Petersburg GBUZ «City Hospital Saint Luka»
Email: zaitsevurology@gmail.com
ORCID iD: 0000-0002-4651-8142
urologist
Russian Federation, Saint PetersburgReferences
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