Pre-op Venous Thromboembolism Prophylaxis Safely Reduced Clots and Pulmonary Emboli

MedicalResearch.com Interview with:
Luke V. Selby, MD
Research Fellow, Department of Surgery
Vivian E. Strong, MD FACS
Associate Attending Surgeon, Department of Surgery
Memorial Sloan Kettering Cancer Center

Medical Research: What is the background for this study? What are the main findings?

Response: There was strong concern at our institution about the safety of providing pre-operative Venous Thromboembolism (VTE) chemoprophylaxis (in addition to our standard peri and post-operative prophylaxis) was unsafe.  To answer this question we administered a single dose of either low molecular weight heparin or unfractionated heparin to all eligible surgical patients at our institution over a six month period. When compared to identically selected patients operated on during the preceding 18 months, patients who received the pre-operative VTE chemoprophylaxis did not have higher rates of bleeding complications and had lower rates of DVT and pulmonary embolism (PE).

Medical Research: What should clinicians and patients take away from your report?

Response: The addition of a single dose of pre-operative Venous Thromboembolism prophylaxis to peri and post-operative VTE prophylaxis was safe in appropriately selected patients undergoing major cancer operations.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: We believe that the pre-operative administration of Venous Thromboembolism chemoprophylaxis is safe in major surgical oncology procedures. We have changed our institutional policies so that all patients who meet our inclusion criteria now receive 5,000 units of unfractionated heparin, subcutaneously, within two hours prior to their operation. We believe all surgeons should examine their institutional VTE prophylaxis policies and strongly consider instituting pre-operative Venous Thromboembolism prophylaxis if they do not already do so.

Citation:

Luke V. Selby, MD et al. Preoperative Chemoprophylaxis Is Safe in Major Oncology Operations and Effective at Preventing Venous Thromboembolism. Journal of the American College of Surgeons, December 2015 DOI: 1016/j.jamcollsurg.2015.11.011

Vivian E. Strong, MD FACS (2015). Pre-op Venous Thromboembolism Prophylaxis Safely Reduced Clots and Pulmonary Emboli 

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