Hemorrhagic and thrombotic complications following robotic-assisted prostatectomy (RALP) with risk-adapted antithrombotic prophylaxis: A retrospective study

BACKGROUND: Despite advances in robotic-assisted prostatectomy and enhanced postoperative rehabilitation protocols, approximately 20% of patients still experience complications - most frequently hemorrhagic. To evaluate the effect of discontinuing systematic PAP (pharmacologic anticoagulant prophylaxis) on postoperative complications - specifically hemorrhagic and thrombotic events - after robotic-assisted prostatectomy. METHODS: In this retrospective before-and-after study, 361 consecutive patients undergoing prostatectomy at a single center were included. Group I (n=173) received systematic PAP with low molecular weight heparin for 28 days postoperatively, alongside routine physical prophylaxis (early mobilization, adequate hydration, and intraoperative leg compression). Group II (n=188) received only routine physical prophylaxis. The primary endpoints were hemorrhagic and thrombotic complications. RESULTS: Clavien-Dindo≥II complications were significantly more frequent in Group I (20.2%) compared to Group II (12.2%, P