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PO-37 - Optimization of the anticoagulant therapy in cancer patients
1Faculty of an obstetrics and gynecology, The First Moscow State Medical Sechenov University, Moscow, Russia.
Introduction:
Thrombophilia is a serious risk factor for cancer patients.
Aim:
To determine the optimal mode of appointment of antithrombotic prophylaxis in perioperative period in cancer patients.
Materials And Methods:
The study involved 889 patients with gynecological cancer in the perioperative period. Group I - LMWH for 10days before surgery 0.3ml, cessation of therapy 24hours before surgery, then 0.3ml for 10days postoperatively - 213 patients Group II - LMWH 24hours before surgery, then 0.3ml for 10days in postoperative period - 212 Group III - LMWH 0.3ml for 10days postoperatively - 216 Group IV - unfractionated heparin 5000IU 3 times a day for 10days in the postoperative period - 248.
Results:
Before surgery rate of subcompensated DIC was 18.5-50%. After surgery rate of subcompensated DIC has increased significantly to 52-75%. In group I, normal levels of DIC markers (TAT, PF4, F1+2) has been observed in 1-3 days. In group II normalization of DIC markers has been observed in 3-5 days. In group III DIC markers tended to normalize in 5-7 days. In group IV normalization of DIC markers has been detected only on the 7th day. D-dimer in some patients remained heightened for up to 10days. In addition, 28 patients (13.7%) formed extensive bruising in the painful injection.
Conclusions:
The proposed scheme prophylaxis: LMWH 10days before surgery and cancel 24hours prior to surgery, then 0.3ml for 10days in the postoperative period - virtually eliminates the risk of thrombosis and contributes normalization of DIC markers in 3days. This scheme could be recommended for all cancer patients as a minimum program.
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