title: The use of enoxaparin to prevent venous thromboembolism in patients undergoing radical retropubic prostatectomy: feasibility and utility.
abstract: OBJECTIVE
  To assess the utility of enoxaparin in prevention of venous thromboembolism (VTE) in men poorly compliant with pneumatic compression stockings (PCS) in the immediate postoperative period after a radical retropubic prostatectomy (RP).
  
  
  METHODS
  This retrospective study included 47 men who underwent RP at an inner-city tertiary care hospital. All patients were started on enoxaparin 40 mg subcutaneously 6-8 hours postoperatively and daily while hospitalized. Preoperative, operative, and postoperative data were collected and analyzed. Median follow-up was 18 months.
  
  
  RESULTS
  Median patient age was 64 +/- 7 years, median prostate-specific antigen level was 4.9 ng/mL and median prostate biopsy-determined Gleason score was 6. Forty-one men (87%) underwent a pelvic lymph node dissection. Median operative time was 181 minutes (range 164-450 minutes). Median estimated blood loss was 700 mL. Approximately 36% of the men wore PCS the recommended > 19 hours/day. On average PCS were worn 10.3 +/- 7.5 hours/day. Postoperative complications were not increased in this cohort. Two patients developed pulmonary embolism requiring long-term anticoagulation. There were no mortalities.
  
  
  CONCLUSIONS
  In men non-compliant with PCS, initiation of enoxaparin in the immediate postoperative setting was well-tolerated and maintained a low (4%) rate of VTE. Thus, enoxaparin may be useful in adjunct with PCS in these patients.
authors.affiliation: Division of Urology, University of Florida, Jacksonville, Florida, USA.
authors.forename: Kogenta
authors.initials: K
authors.lastname: Nakamura
authors.forename: Ali
authors.initials: A
authors.lastname: Kasraeian
authors.forename: Saif
authors.initials: S
authors.lastname: Yacoub
authors.forename: John
authors.initials: J
authors.lastname: Pendleton
authors.forename: Satoshi
authors.initials: S
authors.lastname: Anai
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Rosser
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D017984:Enoxaparin / Q000008:administration & dosage / Q000627:therapeutic use*; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D008197:Lymph Node Excision / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin