To determine whether a single dose of pre-operative enoxaparin for venous thromboembolism (VTE) prophylaxis impacts rates of thrombotic and bleeding events after robotic partial nephrectomy (RPNx).
A retrospective cohort study of RPNx patients from 2009-2020 was performed. Clinical characteristics and peri-operative outcomes were compared between patients receiving a single dose of pre-operative enoxaparin and those who did not. The primary outcome was 30-day hemorrhagic complications (transfusion ≥2 units, embolization, or re-operation for bleeding). Secondary outcomes were 30-day VTE events. Multivariable logistic regression was performed to control for significant differences between groups and to identify predictors of hemorrhagic complications among patients.
Among 945 RPNx procedures, 794 (84%) received pre-operative enoxaparin (PPx) and 151 (16%) did not (NPPx). The PPx cohort was older (p=0.004), had lower BMI (p=0.03), lower ASA class (p=0.049), and fewer smokers (p=0.03). Warm ischemia time was longer for PPx patients (p 0.05).
Similar rates of thrombotic and bleeding events occurred between patients receiving pharmacologic prophylaxis and those who did not. Single dose of pre-operative enoxaparin did not significantly alter perioperative outcomes after RPNx.

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