The safety profile of preoperative administration of heparin for thromboprophylaxis in Chinese patients intended for thoracoscopic major thoracic surgery: a pilot randomized controlled study

Deng, Han‐Yu; Shi, Chang-Lin; Li, Gang; Luo, Jun; Wang, Zhiqiang; Lin, Yi‐Dan; Liu, Lunxu; Zhou, Qinghua

doi:10.21037/jtd.2017.03.148

Cited by 11 publications

(12 citation statements)

References 24 publications

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“…A significant difference has been detected at the time of the first dose usage preoperatively, but no clue on postoperative patients. A literature (18) demonstrated that it is safe and feasible to take preoperative use of heparin for thromboprophylaxis in Chinese patients. However, due to the usage risks of heparin, the timing of anticoagulation is important.…”

Section: Discussionmentioning

confidence: 99%

The significance of perioperative coagulation and fibrinolysis related parameters after lung surgery for predicting venous thromboembolism: a prospective, single center study

Tian

Song

et al. 2018

J. Thorac. Dis.

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Background: The high incidence of venous thromboembolism (VTE) has been perceived in post thoracic surgery patients. However, the significance of perioperative coagulation and fibrinolysis related parameters after lung surgery for VTE predicting is not clear. To investigate that, we conducted a prospective single center study. Methods: A total of 111 patients undergoing lung surgery were enrolled in this study, included 52 primary were received further computer tomography pulmonary angiography (CTPA) for pulmonary embolism (PE).We used the area under receiver-operating-characteristic (ROC) curve to discriminate patients between those who developed VTE and those who did not. Single factor analysis was utilized to define risk factors associated with VTE. Results: The overall incidence of VTE was 16.2% (18/111). The incidence of VTE in primary lung cancer patients was 23.1% (12/52), much higher than that in benign lung diseases 10.2% (6/59), but did not reach statistical significance (P=0.066). Among 18 VTE patients, 83.3% was DVT, 16.7% was DVT + PE and 72.2% was muscular veins of the calf thrombosis. D-Dimer was much higher in VTE group than that in non-VTE group preoperatively and at postoperative days 1, 3 (0.64±0.24 vs. 0.33±0.06, P=0.007; 3.14±0.75 vs. 1.51±0.09, P=0.005, and 1.88±0.53 vs. 0.76±0.05, P=0.001, respectively). And the ROC curve areas of preoperative and postoperative days 1, 3 of D-Dimer were 0.70, 0.71 and 0.74, respectively. And FDP was much higher in VTE group than that in non-VTE group at postoperative day 3 (6.78±1.43 vs. 3.79±0.15, P=0.004). But AT, PT, PA, PR, INR, APTT, FBG and TT there were no significantly difference. Conclusions:The overall incidence of VTE after lung surgery was 16.2%. The patients with preoperative high D-Dimer should receive VTE prophylaxis.

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Section: Discussionmentioning

confidence: 99%

The significance of perioperative coagulation and fibrinolysis related parameters after lung surgery for predicting venous thromboembolism: a prospective, single center study

Tian

Song

et al. 2018

J. Thorac. Dis.

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“…Moreover, almost patients had no major postoperative complications such as severe pulmonary infection and bronchopleural fistula, except one patient who underwent esophagectomy suffered anastomosis leakage and secondary pulmonary infection. Chest drainage tube duration (days) 4.22 [1][2][3][4][5][6][7][8][9][10] Treated with conservative therapies including mixed nutrition of enteral and parenteral alimentation, thoracic cavity drainage, anti-infection, electrolyte balance and other symptomatic treatments, the patient recovered well and discharged with stable vital signs and ability to have half-fluid food. Another one experienced right pneumothorax when the chest drainage tube was removed, then chest drainage tube was administrated again until the symptoms disappeared and the DR image of chest showed well.…”

Section: Resultsmentioning

confidence: 99%

“…The development of VTE is associated with surgery, malignant cancers, age, immobilization, obesity, history of VTE, infection, radiotherapy (1,4). So there is no doubt that the patients diagnosed with malignant neoplasm have a higher risk suffering VTE, especially those with surgical resection (5). Cancer patients were reported to have around 5-to 7-fold higher risk of VTE compared with normal population (6).…”

Section: Introductionmentioning

confidence: 99%

The influence of heparin on coagulation function of patients undergoing video-assisted major thoracic surgery

Alai

Deng

et al. 2018

J. Thorac. Dis.

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Background: Venous thromboembolism (VTE) remains a common complication after major thoracic surgery, especially resection of lung or esophagus cancer. This trial aims to explore the influence of preoperative usage of heparin on coagulation function of patients treated with video-assisted major thoracic Conclusions: All patients underwent video-assisted major thoracic surgery with preoperative use of heparin, there were significant differences in coagulation function after operation. However, mean values of all coagulation parameters stayed normal range clinically. In a word, the method showed no influence on coagulation function clinically.

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“…Thromboprophylaxis often starts postoperatively in thoracic surgical patients (21). Deng et al recommended preoperative DVT prophylaxis with heparin in patients intended for major thoracic surgery (22). DVT may develop during surgery due to venous stasis and the release of thrombogenic substances from lung tissue (8).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of intraoperative administration of intermittent pneumatic compression in preventing deep vein thrombosis in lung cancer patients undergoing video-assisted thoracoscopic surgery lobectomy

Wang¹,

Song²,

Ni³

et al. 2019

J. Thorac. Dis

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Background: This study aimed to determine the effectiveness of intermittent pneumatic compression (IPC) in the prevention of deep vein thrombosis (DVT) in lung cancer patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy. Methods: This study included 495 lung cancer patients undergoing VATS from March 2018 to November 2018. Patients were randomly assigned to an IPC group or a control group using sealed envelopes containing a slip indicating the allocation. IPC calf sleeves were applied to both legs during the surgery. All patients were subjected to D-dimer and echo color-Doppler detection pre-and postoperatively. The incidences of DVT were compared between the two groups. Results: While D-dimer levels failed to show any significant difference between the two groups, the incidence of DVT showed significant difference with respect to the ultrasonographic features of the thrombi. Intraoperative administration of IPC significantly reduced the risk of DVT compared with no mechanical prophylaxis (P<0.0001). No complications related to IPC occurred. Conclusions: Intraoperative administration of IPC was effective in preventing postoperative DVT in lung cancer patients undergoing VATS.

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The safety profile of preoperative administration of heparin for thromboprophylaxis in Chinese patients intended for thoracoscopic major thoracic surgery: a pilot randomized controlled study

Abstract: NCT02940444 (https://register.clinicaltrials.gov/).

Cited by 11 publications

References 24 publications

The significance of perioperative coagulation and fibrinolysis related parameters after lung surgery for predicting venous thromboembolism: a prospective, single center study

The significance of perioperative coagulation and fibrinolysis related parameters after lung surgery for predicting venous thromboembolism: a prospective, single center study

The influence of heparin on coagulation function of patients undergoing video-assisted major thoracic surgery

Effectiveness of intraoperative administration of intermittent pneumatic compression in preventing deep vein thrombosis in lung cancer patients undergoing video-assisted thoracoscopic surgery lobectomy

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