Prolonged thromboprophylaxis for abdominal surgery

Rasmussen, Morten; Wille‐Jørgensen, Peer

doi:10.1002/14651858.cd004318

Cited by 9 publications

(5 citation statements)

References 6 publications

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“…The rate of all‐sites general surgery DVT in this study (7.3–17.4 %), although lower than the 15–40 % estimation proposed in the ACCP guidelines [1], may approach some rates reported in Western systematic reviews (Mismetti et al [37], 14.5 % five studies n = 513; Jorgensen et al [38], 12.3 % two studies n = 138; Rasmussen et al [39]; 13.8 %), but most thrombi were distal and therefore less significant.…”

Section: Discussioncontrasting

confidence: 65%

The Rate and Mortality of Postoperative Venous Thromboembolism of Moderate Risk Surgery in Asian Patients without Thrombo‐prophylaxis: Systematic Review with Meta‐analysis

et al. 2013

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Section: Discussioncontrasting

confidence: 65%

The Rate and Mortality of Postoperative Venous Thromboembolism of Moderate Risk Surgery in Asian Patients without Thrombo‐prophylaxis: Systematic Review with Meta‐analysis

et al. 2013

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“…Pharmacological thromboprophylaxis with low molecular weight heparin (LMWH) or unfractionated heparin has been shown to reduce the incidence of symptomatic venous thromboembolism and also overall mortality with a very low risk of bleeding complications. A single administration of LMWH per day was as effective as twice‐daily administration [279, 280]. A combination of ICP together with pharmacological prophylaxis decreased the incidence of pulmonary embolism (PE) and DVT when compared with a single modality at the expense of higher risk for bleeding complications when comparing to ICP alone [277].…”

Section: Evidence Base and Recommendationsmentioning

confidence: 99%

“…The usefulness of extended thromboprophylaxis (ETP) for 28 days after colorectal surgery relies on data from traditional perioperative care. Based on a Cochrane meta‐analysis of four RCTs [279], previous ERAS recommendations and other guidelines (NICE, NHMRC) recommended ETP (28 days) for patients having major cancer surgery in the abdomen or pelvis. However, with changes in surgical techniques from open to minimally invasive and advances towards less stress with modern anaesthesia, the extended prophylaxis regime has been questioned.…”

Section: Evidence Base and Recommendationsmentioning

confidence: 99%

Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations: 2018

et al. 2018

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Background: Transanal dissection of the rectum has been recently introduced for ileal pouch-anal anastomosis (IPAA) in UC showing promising results. Thanks to the precise identification of the rectotomy site the risk of long rectal stump is avoided, and a single stapled anastomosis is performed easily. The aim of this study is to analyze our initial experience of transanal IPAA (Ta-IPAA), considering postoperative complications and medium-term functional outcomes. Methods: Our Center has experienced the transanal approach for proctectomy and IPAA since October 2018. All patients underwent Enhanced Recovery After Surgery (ERAS) protocol. Postoperative complications occurring within 30 days after surgery were taken into consideration. Results: Until March 2019, 8 patients underwent Ta-IPAA. In all cases the laparoscopic approach was performed during the transabdominal phase; abdominal drainage was never used. At the time of the pouch construction a defunctioning ileostomy was created in all patients. Stoma closure was performed in all cases at a median time of 6 months after surgery. Postoperative complications occurred in only one patient, who showed rectal bleeding. There were no cases of anastomotic leakage. Medium-term functional outcomes were determined prospectively by a validated questionnaire (Cleveland Global Quality of Life). Fecal incontinence for liquid or solid stool, restriction in work and social genitourinary and sexual functions were also investigated. Conclusions: In our experience, Ta-IPAA provided good short and medium-term functional results in UC. Background Restorative proctocolectomy is widely adopted in the treatment of ulcerative colitis ,, , as well as in other inflammatory and neoplastic conditions, requiring an ileal pouch-anal anastomosis (IPAA) to reconstruct gastrointestinal continuity to the anus. Conventionally, either the laparoscopic or the open approach can be employed to gain rectal dissection and creation of ileal pouch-anal anastomosis. Pouch-anal anastomosis is usually made using a stapler, leaving a 2 cm rectal cuff in order to preserve continence and to reduce the risk of inflammatory recurrence or dysplasia. The dissection of the last centimeters of the rectum, rectum resection and ileal pouch-anal anastomosis could be demanding from a technical point of view due to narrow pelvic space and cross stapling of the distal part of the rectum is often challenging for surgeons. Transanal total mesorectal excision (TaTME) has been recently described in rectal cancer treatment, with potential technical and oncologic advantages compared to transabdominal approach. The transanal approach for the proctectomy has been described also in IPAA since 2015, showing feasibility and potential technical advantages; some series ,,, and initial comparative studies have been published , , showing a not increased rate of postoperative morbidity, equivalent quality of life and functional results. The aim of our study is to analyze a single centre experience of transanal IPAA (Ta-IPAA), examining e...

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“…A randomized clinical trial comparing VTE incidence in LMWH once‐a‐day patients with twice‐a‐day patients showed an advantage for the latter group without an increased risk of bleeding [213]. Injections are usually started 2–12 h before surgery and should be continued for 4 weeks after the operation [214]. The use of LMWH in relation to the epidural catheter is based on its dosing frequency.…”

Section: Non‐procedures Specificmentioning

confidence: 99%

Guidelines for Perioperative Care in Esophagectomy: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

et al. 2018

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Introduction Enhanced recovery after surgery (ERAS) programs provide a format for multidisciplinary care and has been shown to predictably improve short term outcomes associated with surgical procedures. Esophagectomy has historically been associated with significant levels of morbidity and mortality and as a result routine application and audit of ERAS guidelines specifically designed for esophageal resection has significant potential to improve outcomes associated with this complex procedure. Methods A team of international experts in the surgical management of esophageal cancer was assembled and the existing literature was identified and reviewed prior to the production of the guidelines. Well established procedure specific components of ERAS were reviewed and updated with changes relevant to esophagectomy. Procedure specific, operative and technical sections were produced utilizing the best current level of evidence. All sections were rated regarding the level of evidence and overall recommendation according to the evaluation (GRADE) system. Results Thirty-nine sections were ultimately produced and assessed for quality of evidence and recommendations. Some sections were completely new to ERAS programs due to the fact that esophagectomy is the first guideline with a thoracic component to the procedure. Conclusions The current ERAS society guidelines should be reviewed and applied in all centers looking to improve outcomes and quality associated with esophageal resection.

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Prolonged thromboprophylaxis for abdominal surgery

Cited by 9 publications

References 6 publications

The Rate and Mortality of Postoperative Venous Thromboembolism of Moderate Risk Surgery in Asian Patients without Thrombo‐prophylaxis: Systematic Review with Meta‐analysis

The Rate and Mortality of Postoperative Venous Thromboembolism of Moderate Risk Surgery in Asian Patients without Thrombo‐prophylaxis: Systematic Review with Meta‐analysis

Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations: 2018

Guidelines for Perioperative Care in Esophagectomy: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

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Prolonged thromboprophylaxis for abdominal surgery

Cited by 9 publications

References 6 publications

The Rate and Mortality of Postoperative Venous Thromboembolism of Moderate Risk Surgery in Asian Patients without Thrombo‐prophylaxis: Systematic Review with Meta‐analysis

The Rate and Mortality of Postoperative Venous Thromboembolism of Moderate Risk Surgery in Asian Patients without Thrombo‐prophylaxis: Systematic Review with Meta‐analysis

Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations: 2018

Guidelines for Perioperative Care in Esophagectomy: Enhanced Recovery After Surgery (ERAS®) Society Recommendations

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Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations: 2018

Guidelines for Perioperative Care in Esophagectomy: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations