Current opinion in urology
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Review
Perioperative venous thromboembolism in urologic oncology procedures, risk factors, and prevention.
Venous thromboembolism (VTE) is a common complication during the perioperative period for major urologic oncology operations. The present review focuses on the risk factors, the mechanisms of hypercoagulability in this patient population, and the timing and prevention of VTE. ⋯ VTEs are common and can potentially be fatal. Prevention in high-risk patients during the most vulnerable perioperative time period should be the focus of clinical efforts to reduce VTE complications and the associated morbidity and mortality.
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Hospital and surgical volumes, as well as complications, are considered to influence intra and postoperative results in most surgical operations. This trend is also seen in uro-oncologic surgery. The objective of this review is to critically analyze the most recent literature to give a comprehensive overview on whether surgical and hospital volumes have an impact, and whether regionalization of the procedure should be advised. ⋯ Regionalization of the procedure in high-volume centers seems to have impact on postoperative morbidity and mortality for the most frequent major uro-oncological procedures: radical prostatectomy, radical cystectomy, and partial nephrectomy; but there are insufficient data available on other procedures.