NDLI: Influence of low-molecular-weight heparin dosage on red blood cell transfusion, lymphocele rate and drainage duration after open radical prostatectomy.

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Influence of low-molecular-weight heparin dosage on red blood cell transfusion, lymphocele rate and drainage duration after open radical prostatectomy.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Schmitges, J. Trinh, Q-D Jonas, L. Budäus, L. Larbig, R. Schlomm, T. Karakiewicz, P. I. Heinzer, H. Huland, H. Graefen, M. Steuber, T.
Description	Country affiliation: Germany Author Affiliation: Schmitges J ( Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany. janschmitges@gmx.de)
Abstract	BACKGROUND: To assess the rates of red blood cell (RBC) transfusions, pelvic lymphoceles, and prolonged drainage duration in patients after radical prostatectomy (RP) receiving perioperative bridging with low-molecular-weight heparin (LMWH). PATIENTS AND METHODS: Between 2006 and 2009, 114 RP patients receiving bridging therapy with 60 mg (n = 63) or ≥80 mg (n = 51) Enoxaparin/d were compared to 1327 consecutive RP patients receiving 40 mg Enoxaparin/d. Logistic regression models were used to test the effect of LMWH dosage on all three outcomes. Covariables included age, body mass index (BMI), Charlson comorbidity index (CCI), prostate volume, pelvic lymph node dissection, and pathological stage. RESULTS: The RBC transfusion rates in patients treated with 40, 60 and ≥80 mg were 4.9, 9.5 and 19.6%, respectively (p < 0.001). The respective lymphocele rates were 6.4, 3.2 and 2.0% (p = 0.26). The respective rates of drainage duration of ≥4 days were 6.7, 4.8 and 16.7% (p = 0.088). After adjusting for confounding factors, patients receiving ≥80 mg were 4.1-fold more likely to be transfused than patients receiving prophylactic LMWH (p = 0.02). Similarly, patients receiving ≥80 mg were 3.2-fold more likely to have a drainage duration of ≥4 days than patients receiving prophylactic LMWH (p = 0.03). CONCLUSIONS: Patients with a perioperative bridging with LMWH in RP are more likely to receive a RBC transfusion and to have prolonged drainage duration. Conversely, bridging therapy was not associated with an increased risk of lymphocele formation.
File Format	HTM / HTML
ISSN	07487983
Issue Number	11
Volume Number	38
e-ISSN	15322157
Journal	European Journal of Surgical Oncology (EJSO)
Language	English
Publisher	Elsevier
Publisher Date	2012-11-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline General Surgery Discipline Oncology Anticoagulants Administration & Dosage Drainage Enoxaparin Erythrocyte Transfusion Lymphocele Etiology Prostatectomy Prostatic Neoplasms Surgery Aged Adverse Effects Blood Loss, Surgical Humans Lymph Node Excision Male Middle Aged Pelvis Postoperative Care Journal Article
Content Type	Text
Resource Type	Article
Subject	Surgery Oncology

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Influence of low-molecular-weight heparin dosage on red blood cell transfusion, lymphocele rate and drainage duration after open radical prostatectomy.