The Sin of Omission in Patients Undergoing Radical Cystectomy? - Renal and Urology News

The Sin of Omission in Patients Undergoing Radical Cystectomy?

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A 71-year-old man with a large bladder diverticulum and muscle-invasive high-grade urothelial carcinoma of the bladder has undergone neoadjuvant cisplatin-based chemotherapy and is brought into the operating room for radical cystoprostatectomy and ileal conduit urinary diversion.

AUA Best Practice Guidelines1 recommend routine venous thromboembolic prophylaxis for patients undergoing radical cystectomy. However, in a recent survey, AUA member respondents revealed that over 30% do not routinely use VTE prophylaxis in their practice for patients undergoing RC.2  Answer: Subcutaneous...

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AUA Best Practice Guidelines1 recommend routine venous thromboembolic prophylaxis for patients undergoing radical cystectomy. However, in a recent survey, AUA member respondents revealed that over 30% do not routinely use VTE prophylaxis in their practice for patients undergoing RC.2 

Answer: Subcutaneous heparin injection should be given upon induction of anesthesia.

This case was prepared by Alexander Kutikov, MD, of Fox Chase Cancer Center in Philadelphia.

  1. http://www.auanet.org/content/media/dvt.pdf
  2. Sterious S, Simhan J, Uzzo RG, Gershman B, Li T, Devarajan K, Canter D, Walton J, Fogg R, Ginzburg S, Corcoran A, Smaldone MC, Kutikov A. Familiarity and Self-Reported Compliance with American Urological Association (AUA) Best Practice Recommendations for Use of Thromboembolic Prophylaxis Amongst American Urological Association Members. Journal of Urology, 2013, Epub ahead of print.
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