[Acute pulmonary thromboembolism and deep-venous thrombosis at post-operative period in urologic surgery]

Acute pulmonary thromboembolism (APTE) and deep venous thrombosis (DVT) are categorized into venous thromboembolism. APTE is one of the most critical post-operative complications because of its high mortality. Meanwhile, DVT is responsible for more than 80-95% of APTE cases. APTE occurred in 6 patients and DVT in 3 patients in the post-operative period during the past eleven years at our hospital. The median age of these patients, 5 men and 4 women, was 62 years (45-77). In many cases, the course of APTE showed a rapid progression. Four of the six patients with APTE died, and two of these four patients died within a few hours following the onset. Once it occurs, it is often lethal. Therefore, the prevention of thromboembolism is most important. In this study, we examined these 6 APTE cases and 3 DVT cases and discussed low dose heparin and intermittent sequential pneumatic compression (ISPC), prophylaxis against APTE in the post-operative period. We have been using ISPC for the high-risk group of thromboembolism in the post-operative period since 1999. In addition to using ISPC, we have been administering low dose heparin since November 2001. These 3 cases of DVT occurred regardless of adoption of ISPC. However, there were no cases of APTE after adoption of ISPC, and no cases of DVT or APTE after adoption of ISPC and administration of low dose heparin.