Routine deep venous thrombosis prophylaxis is controversial in Asian patients, because deep venous thrombosis incidence was considered negligible.
Because of recent reports of significantly higher incidences, a randomized, controlled trial was conducted to assess the effectiveness and complications of enoxaparin prophylaxis (low molecular weight heparins) in major colorectal surgery.
Three hundred twenty consecutive patients were randomly assigned to control or low molecular weight heparins groups.
Patients in the low molecular weight heparins group were given perioperative enoxaparin starting 12 hours before surgery.
The surgeon (blinded) assessed for difficulties related to possible enoxaparin administration.
Independent blinded observers performed daily clinical assessments and Doppler studies (at the 3rd and 5th postoperative day).
Deep venous thrombosis was confirmed by duplex ultrasound, and pulmonary embolism was confirmed by lung scans or postmortem examinations.
Deep venous thrombosis developed in 5 of 169 (3 percent) controls and 0 of 134 low molecular weight heparins patients (P=0.045).
Three of the deep venous thrombosis patients had pulmonary embolism, which was fatal in one patient.
The surgeons were unable to perceive any increased surgical difficulties in the low molecular weight heparins group.
The bleeding-related complications were significantly higher in the low molecular weight heparins patients (controls, n=3 (1. (...)
Mots-clés Pascal : Colectomie, Proctocolectomie, Indication, Chimioprophylaxie, Anticoagulant, Héparine bas poids moléculaire, Thrombose, Veine profonde, Asiatique, Etude comparative, Homme, Côlon, Chirurgie, Appareil digestif pathologie, Intestin pathologie, Côlon pathologie, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Veine pathologie
Mots-clés Pascal anglais : Colectomy, Proctocolectomy, Indication, Chemoprophylaxis, Anticoagulant, Low molecular weight heparin, Thrombosis, Deep vein, Asiatic, Comparative study, Human, Colon, Surgery, Digestive diseases, Intestinal disease, Colonic disease, Cardiovascular disease, Vascular disease, Venous disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0154039
Code Inist : 002B02G. Création : 16/11/1999.