J Korean Surg Soc.  2010 Oct;79(4):253-260. 10.4174/jkss.2010.79.4.253.

The Prophylactic Impact of Low Molecular Weight Heparin on Occurrence of Venous Thromboembolism after Colorectal Cancer Resection

• Lee SD
• Park JW
• Park SC
• Kim HJ
• Choi HS
• Oh JH

• KMID: 2145026
• DOI: http://doi.org/10.4174/jkss.2010.79.4.253

Abstract

PURPOSE
In western society, prophylaxis for venous thromboembolism (VTE) is the standard treatment under colorectal surgery for colorectal cancer. However, the incidence of VTE after colorectal surgery and the effect of prophylactic methods are not well known in Korea. The aim of this study is to evaluate the incidence of VTE and assess the efficacy and safety of low molecular weight heparin (enoxaparin) after major colorectal surgery in Korean patients with compression stockings.
METHODS
From Jan. 2006 to Dec. 2008, 1,727 consecutive patients underwent major colorectal surgery. Thirty-six were excluded due to the therapeutic use of enoxaparin. A final number of 1,691 patients were included. Graduated compression stockings were used in all patients and 654 were perioperatively given enoxaparin. Only compression stocking group (group A) and compression stocking with enoxaparin group (group B) were compared in terms of VTE. The event of VTE within 6 months after surgery was counted by clinical symptoms, then imaging findings were used for confirmation.
RESULTS
Total VTE developed in 10 patients (0.6%). Three with deep vein thrombosis had pulmonary embolism. Two had only pulmonary embolism. The rates of VTE were not different between group A and B (0.8% vs. 0.3%, P=0.333). Also, postoperative major bleeding was not significantly different. However, postoperative transfusion was higher in group B (P<0.001).
CONCLUSION
The incidence of VTE was very low after colorectal surgery in Korean patients with compression stockings. The additional use of enoxaparin for colorectal cancer patients with compression stockings seems to have little benefit for VTE prophylaxis.

Keyword

Colorectal cancer; Venous thromboembolism; Enoxaparin

MeSH Terms

Colorectal Neoplasms
Colorectal Surgery
Enoxaparin
Hemorrhage
Heparin, Low-Molecular-Weight
Humans
Incidence
Korea
Pulmonary Embolism
Stockings, Compression
Venous Thromboembolism
Venous Thrombosis
Enoxaparin
Heparin, Low-Molecular-Weight

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