@Article{,
AUTHOR = {Brenton Winship, Neal Patel, Lang Nguyen, Sean Bhalla, 
Alice Semerjian, Thomas Jarrett},
TITLE = {Safety of perioperative subcutaneous heparin for partial nephrectomy},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {22},
YEAR = {2015},
NUMBER = {5},
PAGES = {7990--7994},
URL = {http://www.techscience.com/CJU/v22n5/61223},
ISSN = {1488-5581},
ABSTRACT = {<b>Introduction:</b> The development of deep venous thrombosis 
(DVT) or pulmonary embolism (PE) following urologic 
surgery is a life threatening, but largely preventable 
complication. Patients undergoing partial nephrectomy 
are at increased risk for the development of DVT or PE 
as they often possess multiple risk factors including 
malignancy, advanced age, and prolonged surgical time. 
This risk can be significantly reduced by administration 
of perioperative subcutaneous heparin (SQH), however 
many surgeons feel this is contraindicated due to potential 
blood loss and related complications.<br/>
<b>Materials and methods:</b> The medical records of 
293 consecutive patients undergoing planned open, 
laparoscopic, or robotic assisted partial nephrectomy 
by a single surgeon over a 7 year period were reviewed. 
Approximately halfway through the period, the standard 
DVT prevention practice was changed from sequential 
compression stockings and early ambulation to include 
5000 units of SQH administered 30-60 minutes prior to 
incision and continuing every 8 hours until discharge. <br/>
<b>Results: </b>A total of 158 patients received perioperative 
SQH. There was no significant difference in surgical 
blood loss, transfusions, operative time, change in pre 
to postoperative hemoglobin or creatinine, conversion 
to radical nephrectomy, or duration of stay between the 
groups. There were no DVTs in either group. There 
was one PE in the group receiving SQH which was 
incidentally discovered. <br/>
<b>Conclusions:</b> Patients undergoing renal surgery for 
cancer are at increased risk for the development of DVT 
and PE. Prophylaxis against this serious complication 
with perioperative SQH is safe in patients undergoing 
partial nephrectomy despite common surgeon concerns 
regarding blood loss and related complications.},
DOI = {}
}