在前列腺切除术后患者的静脉血栓栓塞 (VTE):系统性审查和元分析
Mudassir Wani1, Abdullah Al-Mitwalli1, Subhabrata Mukherjee2
1Department of Urology, Swansea Bay University Health Board, Swansea SA6 6NL, UK.
Journal of clinical medicine
|June 28, 2023
概括
根源性前列腺切除术 (RP) 患者发生静脉血栓塞栓症 (VTE) 的发生率为1%. 最少侵入性手术和避免盆腔淋巴结解剖减少了静脉动脉突发症的风险,这表明所有患者可能不需要预防.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 血管外科 血管外科
背景情况:
- 激进前列腺切除术 (RP) 是局部前列腺癌的主要治疗方法.
- 静脉血栓塞栓症 (VTE) 是主要的腹腔皮层手术的已知并发症,如RP.
- 目前的指导方针在泌尿器科手术中缺乏关于VTE预防的共识.
研究的目的:
- 在RP后的患者中系统地审查和元分析VTE发生情况.
- 评估手术方法,骨盆淋巴结解剖 (PLND) 和预防类型对静脉瘤风险的影响.
- 在接受RP的患者中识别VTE发生率和风险因素.
主要方法:
- 进行了全面的文献搜索.
- 来自16项研究的数据被纳入定量分析.
- 在统计分析中使用了DerSimonian-Laird随机效应模型.
主要成果:
- 根源性前列腺切除术后静脉动脉瘤的总发病率为1%.
- 最少侵入性的手术方法 (腹腔镜,机器人) 与静脉瘤风险较低有关.
- 没有骨盆淋巴结解剖 (PLND) 进行的RP也显示了VTE的风险降低.
结论:
- 微创手术和省略PLND可能会降低RP患者的静脉瘤风险.
- 常规的联合药理和机械预防可能不需要所有患者.
- 静脉瘤预防应该是个性化的,专注于接受激进前列腺切除术的高风险患者.
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