Venous thromboembolism (VTE) that includes both pulmonary embolism (PE) and deep vein thrombosis (DVT), is a common complication in major urological oncology surgery and it is one of the significant causes of mortality and morbidity. Effective and quality nursing care and practices at every stage of the perioperative process, from the patient’s initial clinical admission to post-discharge home care can prevent potential complications. The most effective and the easiest way to prevent VTE is to perform a proper risk assessment. Nurses providing care to patients undergoing major urological surgery should conduct a risk assessment through an effective nursing anamnesis in the preoperative period and take necessary precautions for individuals at risk for VTE. These precautions should be planned to encompass the intraoperative and postoperative periods as well. The primary reasons that increase susceptibility to VTE include the pelvic region being the focus of urological surgeries, the majority of patients being elderly, surgeries typically being performed in the lithotomy position, and the relatively extended period of postoperative immobilization. Risk classification, according to national and international guidelines, is categorized as ‘high’ or ‘very high’ risk, with prophylaxis post-discharge considered only for a subset of patients at ‘very high risk.’ VTE prevention is generally achieved through two main approaches: pharmacological and non-pharmacological prophylaxis. Pharmacological prophylaxis reduces the likelihood of VTE, but it is crucial to balance the risk of bleeding with the patient’s experience. Therefore, this review aims to evaluate the role of prophylaxis and nursing management for preventing VTE in major urological surgical procedures.
Abstract
Venous thromboembolism (VTE) that includes both pulmonary embolism (PE) and deep vein thrombosis (DVT), is a common complication in major urological oncology surgery and it is one of the significant causes of mortality and morbidity. Effective and quality nursing care and practices at every stage of the perioperative process, from the patient’s initial clinical admission to post-discharge home care can prevent potential complications. The most effective and the easiest way to prevent VTE is to perform a proper risk assessment. Nurses providing care to patients undergoing major urological surgery should conduct a risk assessment through an effective nursing anamnesis in the preoperative period and take necessary precautions for individuals at risk for VTE. These precautions should be planned to encompass the intraoperative and postoperative periods as well. The primary reasons that increase susceptibility to VTE include the pelvic region being the focus of urological surgeries, the majority of patients being elderly, surgeries typically being performed in the lithotomy position, and the relatively extended period of postoperative immobilization. Risk classification, according to national and international guidelines, is categorized as ‘high’ or ‘very high’ risk, with prophylaxis post-discharge considered only for a subset of patients at ‘very high risk.’ VTE prevention is generally achieved through two main approaches: pharmacological and non-pharmacological prophylaxis. Pharmacological prophylaxis reduces the likelihood of VTE, but it is crucial to balance the risk of bleeding with the patient’s experience. Therefore, this review aims to evaluate the role of prophylaxis and nursing management for preventing VTE in major urological surgical procedures.