Low molecular-weight heparin for thromboprophylaxis in patients undergoing gastric cancer surgery: an experience from one Korean institute

• Published in: Annals of surgical treatment and research Vol. 86; no. 1; pp. 22 - 27
• Main Authors: Choi, Sung Ho, Shim, Jung Ho, Park, Cho Hyun, Song, Kyo Young
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Surgical Society 2014; 대한외과학회
• Subjects: Original; 일반외과학; Feasibility; Low-molecular-weight heparin; Thromboembolism; Stomach cancer; Korea
• ISSN: 2288-6575; 2288-6796
• DOI: 10.4174/astr.2014.86.1.22

This study evaluated the efficacy for preventing venous thromboembolism (VTE) and adverse effects of low-molecular-weight heparin (LMWH) in order to launch a prospective clinical trial in Korea. We reviewed the medical records of 108 consecutive patients who underwent gastric cancer surgery. These patients were divided into 2 groups according to the type of thromboprophylaxis: group A, LMWH combined with intermittent pneumatic compression (IPC); group B, IPC alone. The postoperative outcomes of the two groups were compared. Symptomatic VTE was observed in only 1 patient (0.9%) from group B. Postoperative bleeding was more common in group A than in group B (10.9% vs. 7.5%), although the difference was not significant (P = 0.055). Most bleeding episodes were minor and managed conservatively without intervention. Only a high body mass index was associated with a significantly increased risk of postoperative bleeding (odds ratio, 1.45; 95% confidence interval, 1.12-2.43; P = 0.051). A 40 mg of enoxaparin sodium is a safe and feasible dose for prevention of VTE. With the results of this study, we are planning a prospective randomized clinical trial to investigate the clinical efficacy of LMWH thromboprophylaxis in gastric cancer patients in Korea.