Incidence and risk factors of venous thromboembolism following radical nephrectomy: A meta-analysis of observational studies

Background: A meta-analysis was conducted to evaluate the incidence of venous thromboembolism (VTE) following radical nephrectomy and to examine the related risk factors. Methods: We conducted a comprehensive search for primary research articles from the inception of the databases up to October, 2024 across several databases, including MEDLINE, Embase, and the Cochrane Library. We employed random effects models to determine multivariate adjusted odds ratios (ORs) along with their corresponding 95% confidence intervals (CIs). Results: In total, 11 studies including 140,795 patients who underwent radical nephrectomy met inclusion criteria. The results showed that postoperative VTE incidence was 1.01% (95% CI = 1.01-1.02; p < 0.001) within 30 days. Moreover, diabetes, open nephrectomy, and history of VTE were related to higher odds of VTE through regression analysis. Analyses of sensitivity and meta-regression demonstrated the robustness of the study's findings. Conclusions: The overall incidence of VTE after radical nephrectomy is 1%, occurring approximately one month after surgery, and may be related to factors such as open surgery, diabetes and history of VTE. This reminds urologists that more aggressive thromboprophylaxis may be required for these patients. PROSPERO Registration number: CRD42023439919.