Low Molecular Weight Heparin for Venous Thromboembolism Prophylaxis in Urologic Oncologic Surgery

Sawczuk, Ihor S.; Williams, Dan; Chang, David T.

doi:10.1081/cnv-120005901

Cited by 10 publications

(6 citation statements)

References 9 publications

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“…With the advent of low molecular weight heparins, they have become the most common chemoprophylactic agents for DVT prophylaxis. Many studies have demonstrated lesser complications and greater Operation Group-I (N) Group-II (C) Total Cholecystectomy 5 3 8 CBD exploration 4 4 8 Rectal Operation 3 3 6 Exploratory laparotomy 14 14 28 Adrenalectomy 1 2 3 Oesophagectomy 1 0 1 Ilio-Inguinal lymph node dissection 3 4 7 Nephrectomy 3 1 4 Total 34 31 Table 1 Types of operations performed efficiency of LMWHs in preventing DVT compared to unfractionated heparin [14][15][16][17].…”

Section: Discussionmentioning

confidence: 99%

Detection and Prevention of Post-Operative Deep Vein Thrombosis [DVT] Using Nadroparin Among Patients Undergoing Major Abdominal Operations in India; a Randomised Controlled Trial

et al. 2010

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Deep vein thrombosis [DVT] is one of the most dreaded complications in post-operative patients as it is associated with considerable morbidity and mortality. Majority of patients with postoperative DVT are asymptomatic. The pulmonary embolism, which is seen in 10% of the cases with proximal DVT, may be fatal. Therefore it becomes imperative to prevent DVT rather than to diagnose and treat. Only one randomized trial has been reported from India to assess the effectiveness of low molecular weight heparin in preventing post-operative DVT. To assess the risk of DVT in North Indian patients following major abdominal operations and to evaluate the effectiveness of Nadroparin, A Low Molecular Weight Heparin (LMWH) therapy in preventing post-operative DVT. Sixty five patients were randomised preoperatively into Group-I; Nadroparin prophylaxis and Group-II: No prophylaxis. The primary outcome was the occurrence of DVT, diagnosed by bilateral lower limb venogram performed, seven to ten days after operation. Secondary outcome measures included adverse effects of radio-opaque dye, intra-operative blood loss, operating time, postoperative platelet count, intraoperative blood transfusion requirements and the total duration of postoperative bed rest. No case of DVT occurred in either group. There was no statistical difference in the risk of secondary outcome measures in the two groups. DVT was not observed in any of the patients, even with several high risk factors indicating a possible protective mechanism in the North Indian population.

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Section: Discussionmentioning

confidence: 99%

Detection and Prevention of Post-Operative Deep Vein Thrombosis [DVT] Using Nadroparin Among Patients Undergoing Major Abdominal Operations in India; a Randomised Controlled Trial

et al. 2010

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“…Very few studies have evaluated thromboprophylaxis in other surgical oncology settings, including thoracic (Cade et al , 1983; Azorin et al , 1997), urologic (Bigg & Catalona, 1992; Sawczuk et al , 2002) and orthopaedic surgery (Lin et al , 1998). Based on limited published data, it appears that prophylaxis with either UFH or LMWH is effective and relatively safe, but properly conducted studies are needed to address the issue in each surgical setting separately.…”

Section: Surgical Settingmentioning

confidence: 99%

Section: Surgical Settingmentioning

confidence: 99%

Management of thrombosis in cancer: primary prevention and secondary prophylaxis

Lee

2005

Br J Haematol

102

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SummaryAlthough traditional anticoagulant regimens are highly effective and safe in most patients with venous thromboembolism (VTE), the aggressive natural history of VTE and the high risk of serious bleeding in cancer patients can complicate the management of VTE. In addition, because few clinical trials have focused on the prevention and treatment of VTE in this unique patient population, many clinical questions regarding the care of cancer patients with VTE remain unanswered. Currently, low-molecular-weight heparins and oral vitamin K antagonists are the most commonly used agents for the primary and secondary prophylaxis of VTE in patients with or without cancer, but their use is associated with pharmacological and practical limitations. This review will provide an up-to-date summary of the clinical trials that have addressed the management of VTE in patients with cancer. A brief discussion of the potential application of novel anticoagulants in these clinical settings is also included.

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“…In the study conducted by Sawczuk on 38 patients qualified for elective urologic cancer surgery, dalteparin (2500 units s.c., prophylaxis began 1-2 hours before surgery) along with intermittent pneumatic compression was used. Within 3-7 days of thromboembolism prophylaxis, there was no symptomatic VTE episode diagnosed and at the same time, no excessive bleeding was observed [232]. Koch assessed the effectiveness of enoxaparin administered an hour before surgery at the dose of 30 mg (and next after 12 hours) in patients undergoing open prostatectomy and did not report symptomatic VTE events in the group receiving prophylaxis, whereas 3.3% in the controls, who used only compression means, presented with thromboembolic events [233].…”

Section: Venous Thromboembolism Prophylaxis In Cancer Patientsmentioning

confidence: 93%

“…anti-androgen treatment), and, as in other medical fields, clinically significant concomitant disease presence [14,[205][206][207][208]. The presence of cancer also increases the risk for symptomatic VTE occurrence after upper urinary tract surgeries up to 1-5% [14,179,12,183].…”

Section: Venous Thromboembolism Prophylaxis In Cancer Patientsmentioning

confidence: 99%

Venous thromboembolism prophylaxis in cancer patients — guidelines focus on surgical patients

Urbanek¹,

Krasiński

Kostrubiec

et al. 2017

Acta Angiologica

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Low Molecular Weight Heparin for Venous Thromboembolism Prophylaxis in Urologic Oncologic Surgery

Abstract: Low molecular weight heparins appear promising for DVT prophylaxis in high-risk urology patients.

Cited by 10 publications

References 9 publications

Detection and Prevention of Post-Operative Deep Vein Thrombosis [DVT] Using Nadroparin Among Patients Undergoing Major Abdominal Operations in India; a Randomised Controlled Trial

Detection and Prevention of Post-Operative Deep Vein Thrombosis [DVT] Using Nadroparin Among Patients Undergoing Major Abdominal Operations in India; a Randomised Controlled Trial

Management of thrombosis in cancer: primary prevention and secondary prophylaxis

Venous thromboembolism prophylaxis in cancer patients — guidelines focus on surgical patients

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