Extended duration chemoprophylaxis for venous thromboembolism following abdominopelvic oncologic surgery

Kanitra, John J.; Holtrop, John; Jawad, Ali; Berri, Richard N.

doi:10.1007/s11239-019-02002-9

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…Nineteen studies with a total of 10,544 patients were included in the final analysis-nine randomized controlled trials [8,[20][21][22][23][24][25][26][27], four prospective studies [7,15,28,29], four retrospective studies [30][31][32][33], and two prospective experimental cohorts compared with historic cohorts [34,35] (Table 1). All but two studies had comparator groups [15,32].…”

Section: Study Characteristicsmentioning

confidence: 99%

Is Extended‐Duration (Post‐Hospital Discharge) Venous Thromboembolism Chemoprophylaxis Safe and Efficacious in High‐Risk Surgery Patients? A Systematic Review

et al. 2020

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Background The risk of venous thromboembolism (VTE) persists beyond hospitalization in surgical patients, yet post-hospital discharge chemoprophylaxis regimens are not common. The purpose of this study is to systematically review the literature regarding extended-duration (post-hospital discharge) venous thromboembolism chemoprophylaxis and to determine whether it is warranted in high-risk surgical patients, as determined by its safety and efficacy. Method We searched four online databases for articles evaluating extended-duration (post-hospital discharge) VTE chemoprophylaxis regimens in surgical patients between the years January 2000 and February 2020. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used. GRADE methodology and the Cochrane Risk of Bias Assessment Tool for Randomized Controlled Trials were used to grade the quality of evidence and assess risk of bias. Results Nineteen studies with 10,544 patients were analyzed. The duration for extended-duration VTE chemoprophylaxis ranged from 7 to 42 days. In our study cohort, high-risk patients not prescribed extended-duration VTE chemoprophylaxis had a mean VTE incidence rate of 12.23%, while patients receiving 28-30 days of chemoprophylaxis had a mean VTE incidence rate of 4.37% (p = 0.006). The risk of bleeding events did not correlate with the duration of chemoprophylaxis. Conclusion Extended-duration VTE chemoprophylaxis in high-risk surgical patients decreased the incidence of thrombotic complications without increasing the risk of bleeding events. Further research is needed to establish guidelines for the optimal duration of VTE chemoprophylaxis in high-risk surgical patients. Level of evidence III.

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Section: Study Characteristicsmentioning

confidence: 99%

Is Extended‐Duration (Post‐Hospital Discharge) Venous Thromboembolism Chemoprophylaxis Safe and Efficacious in High‐Risk Surgery Patients? A Systematic Review

et al. 2020

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“…6,23 However, multiple cohort and observational studies have demonstrated a significant reduction in symptomatic VTE between CP and ETP groups. 31 The meta-analysis of these four observational studies by Fagarasanu et al 4 hence showed a significant reduction in the overall incidence of symptomatic VTE with ETP. Furthermore, by showing a significant reduction in the rates of objectively diagnosed VTE, that is a 'surrogate marker' for VTE, the RCTs have in fact shown that ETP would similarly reduce the rates of symptomatic and clinically relevant VTE.…”

Section: Published Systematic Reviewsmentioning

confidence: 95%

“…found the NNT to avoid one case of objectively diagnosed VTE to be three while the NNT to avoid one symptomatic case of VTE was 66 due to the much lower rate of symptomatic VTE 6,23 . However, multiple cohort and observational studies have demonstrated a significant reduction in symptomatic VTE between CP and ETP groups 31 . The meta‐analysis of these four observational studies by Fagarasanu et al 4 .…”

Section: Methodsmentioning

confidence: 99%

Extended chemothromboprophylaxis use in colorectal cancer surgery: a literature review

Chakraborty

Jacob

2022

ANZ Journal of Surgery

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Venous thromboembolism (VTE) is a potentially fatal condition associated with chronic morbidity. Patients undergoing colorectal cancer surgery have an especially high rate of VTE postoperatively. This risk continues to be elevated for up to 3 months after discharge, hence arises the question of extended thromboprophylaxis (ETP). The objective of this literature review is to summarize the current literature on ETP post colorectal cancer surgery. The results of five randomized controlled trials (RCT), several meta-analysis and five major guidelines are outlined and examined. The literature overwhelmingly supports the use of ETP in colorectal cancer surgery. The key limitation of the evidence base is the use of objective tests to diagnose VTE which also detect asymptomatic events. However, this surrogate marker has been reliably shown to correlate with symptomatic VTE. In other high-risk populations such as orthopaedic patients, similar research has led to the use of routinely prescribed ETP. There is evidence now that the use of ETP is cost-effective in reducing morbidity and mortality from VTE in colorectal cancer patients. However, despite strong evidence on the benefits of ETP in colorectal cancer surgery, it is not yet a routine clinical practice. Future research is required to determine the optimal duration of chemothromboprophylaxis in different subgroups within colorectal cancer patients such as patients with rectal cancer only or those undergoing minimally invasive surgery.

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Justification of Choice of Thromboprophylaxis Method in Patients with High-Risk Surgical Profile: A Literature Review

Katelnitskiy

Nemirovich

Простов

et al. 2022

I.P. Pavlov Russian Medical Biological Herald

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INTRODUCTION: Venous thromboembolic complications (VTEC) such as deep and subcutaneous vein thrombosis and pulmonary embolism are the most important clinical problems in many specialties. High-risk factors for thrombus formation include surgical interventions leading to the activation of the hemostatic system. Despite the existing international and Russian clinical recommendations on the treatment and prophylaxis of VTEC containing a detailed description of the methods and algorithms of prophylaxis in patients with different nosologies including patients with polymorbidities, the incidence of VTEC remains high. In the scientific community, there is a continuing discussion of the effectiveness of various approaches to VTEC prophylaxis in different clinical groups of patients. Algorithms available prescribe anticoagulants at standard doses and combinations. However, in patients with comorbidities, isolated conservative anticoagulant therapy may be insufficient for effective VTEC prophylaxis. CONCLUSION: Currently, there is a need to improve the algorithms of VTEC prophylaxis in patients with comorbid pathologies to elaborate clear indications for the use of both pharmacological and mechanical prevention methods and their combinations.

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Extended duration chemoprophylaxis for venous thromboembolism following abdominopelvic oncologic surgery

Cited by 3 publications

References 11 publications

Is Extended‐Duration (Post‐Hospital Discharge) Venous Thromboembolism Chemoprophylaxis Safe and Efficacious in High‐Risk Surgery Patients? A Systematic Review

Is Extended‐Duration (Post‐Hospital Discharge) Venous Thromboembolism Chemoprophylaxis Safe and Efficacious in High‐Risk Surgery Patients? A Systematic Review

Extended chemothromboprophylaxis use in colorectal cancer surgery: a literature review

Justification of Choice of Thromboprophylaxis Method in Patients with High-Risk Surgical Profile: A Literature Review

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