LOW-MOLECULAR-WEIGHT HEPARIN AND RADICAL PROSTATECTOMY - A PROSPECTIVE ANALYSIS OF SAFETY AND SIDE-EFFECTS

We prospectively analyzed the safety of the perioperative use of low m olecular weight heparin (LMWH) for prophylaxis of thromboembolic compl ications after radical retropubic prostatectomy (RRP). Seventy-three c onsecutive patients received Enoxaparin, a LMWH compound one hour befo re RRP and then every twelve hours until hospital discharge. A mean of seven doses of LMWH were administered. A comparison was made with a c ontrol group of eighty-nine patients undergoing RRP without anticoagul ant prophylaxis. Estimated blood loss was 515 +/- 215 cc with LMWH pat ients and 611 +/- 471 cc in controls. Total drain output was a mean of 318 cc with LMWH and 300 cc in controls. Seven percent of patients tr eated with enoxaparin developed a wound or operative site hematoma or lymphocele compared with none in the control group. LMWH appears to be a relatively safe means of prophylaxis for thromboembolic complicatio ns after RRP with no apparent increase in intraoperative bleeding or p ostoperative drainage. However, postoperative hemorrhagic complication s or lymphocele formation are slightly increased. LMWH should be consi dered for prophylaxis of thromboembolic complications in high risk ind ividuals but the associated morbidity does not support its routine use .