TITLE:
Clinical Report on Pharmacological Prevention of Deep Vein Thrombosis after Radical Resection of Abdominal Tumors
AUTHORS:
Liang He, Jiang Wang, Lin Nan, Bin Yan, Yongjiu Zhang
KEYWORDS:
Abdominal Tumor; Venous Thrombosis; Surgery
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.5 No.1,
January
8,
2014
ABSTRACT: Aim: The aim of this paper is to summarize the experience
and results of deep vein thrombosis prevention after standardized abdominal
tumor resection and lymph node dissection, and to investigate standardized
treatment methods for postoperative thrombosis prevention. Methods: We
performed a retrospective analysis of the clinical data for 548 patients who
were given low molecular weight heparin, low molecular weight dextran, or IV salvia
to prevent thrombosis development between January 2007 and April 2010 after standardized
abdominal tumor resection and lymph node dissection. Patients were divided into
the following three groups based on the treatment period and treatment schedule:
group 1 included 163 patients who had been treated between January 2007 and
March 2008 and received a 7-day course of daily low molecular weight dextran
(500 mL) and salvia injection (0.2 g)
postoperatively; group 2 included 149 patients who had been treated between
April 2008 and March 2009 and received a 7-day course of daily low molecular
weight dextran (500 mL), salvia injection (0.2 g),
and low molecular weight heparin (40 mg) postoperatively; group 3 included 236
patients who had been treated between April 2009 and April 2010 and postoperatively
received a 7-day course of daily low molecular weight dextran (500 mL) and
salvia injection (0.2 g),
and on postoperative day 3 were started on an additional 7-day course of daily
low molecular weight heparin (40 mg). Then, we performed comparative analysis
of the treatment efficacy and concomitant symptoms. Results: In group 1, 64 of
the 163 cases (39.3%) were positive for D-dimer, and 15 (9.2%) cases were
positive for DVT based on Doppler imaging of the lower extremities. In group 2,
38 cases (25.5%) were positive for D-dimer and 3 cases (2.0%) for DVT. In group
3, 62 cases (26.3%) were positive for D-dimer and 6 cases (2.5%) for DVT. In
general, the administration of low molecular weight heparin for anticoagulation
in groups 2 and 3 led to significant reduction of thromboses when compared to
group 1. However, altering the initiation day of low molecular weight heparin
administration between groups 2 and 3 did not result in significant differences
in the rate of thrombosis formation. Through clinical observation, early
administration of low molecular weight heparin may increase adverse effects. Conclusion:
We have demonstrated the superior efficacy of postoperative administration of
low molecular weight dextran and IV salvia with additional subcutaneous
injection of low molecular weight heparin on postoperative day 3 to prevent DVT
development after radical resection of abdominal tumors.