Thrombus prophylaxis in colorectal surgery

Heparin plus graduated compression stockings appears to be better than heparin alone for thrombus prophylaxis in colorectal surgery.

A Cochrane review included 19 studies. Information on colorectal patients was extracted. Any kind of heparin was better than no treatment or placebo (Peto OR 0.32, 95% CI 0.20 to 0.53; 11 studies, n=641) in preventing deep venous thrombosis (DVT) and/or pulmonary embolism (PE). Unfractionated heparin (LDH) was better prophylaxis against DVT and/or PE compared with no treatment or placebo (Peto OR 0.35, 95% CI 0.20 to 0.62; 8 studies, n=292). Low molecular weight heparin (LMWH) also was better than no treatment or placebo in preventing DVT (Peto OR 0.17, 95% CI 0.05 to 0.54; 3 studies, n=349). The combination of graded compression stockings and LDH was better than LDH alone in preventing DVT or PE (Peto OR 4.17, 95% CI 1.37 to 12.70; 2 studies, n=111).

Comment: The quality of evidence is downgraded by imprecise results (few patients and outcome events).

The following decision support rules contain links to this evidence summary:

• Deep vein thrombosis (DVT) prophylaxis (ICU-3)

Ədəbiyyat

1. Wille-Jørgensen P, Rasmussen MS, Andersen BR et al. Heparins and mechanical methods for thromboprophylaxis in colorectal surgery. Cochrane Database Syst Rev 2003;(4):CD001217. .