Duration of prophylaxis against venous thromboembolism with low molecular weight heparin (enoxaparin) after surgery for abdominal and esophageal cancer : a single institution, prospective, randomized trial in japan

Background: The optimal duration of thromboprophylaxis after surgery for cancer has not been clearly defined in Japan. The aim of this prospective study was to evaluate the efficacy and safety of 3 days of thromboprophylaxis in comparison to 10 days of thromboprophylaxis with low molecular weight heparin (enoxaparin) in patients undergoing elective surgery for abdominal and esophageal cancer.Methods: The study population included patients who were over 40 years of age and who were planning to undergo elective surgery for abdominal and esophageal cancer. 101 patients were randomly assigned to the short thromboprophylaxis (3 days) and long thromboprophylaxis (10 days) groups. Finally, after applying the exclusion criteria, we evaluated 45 patients in each group. The primary efficiency endpoint was the incidence of venous thromboembolism between day 11 and the day of discharge.Results: The incidence rates of distal deep vein thrombosis (DVT) after surgery were 6.7% and 8.9% in the short and long thromboprophylaxis groups, respectively. (p = 0.50). There was no significant difference. Conclusions: We concluded that if pharmacological thromboprophylaxis with enoxaparin was combined with mechanical methods in patients undergoing elective surgery for cancer, then the adequate duration of routine thromboprophylaxis with enoxaparin was only 3 days.

low molecular weight heparin

enoxaparin

venous thromboembolism

surgery