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One Size Does Not Fit All: Venous Thromboembolism Prophylaxis in Colorectal Cancer
Gabrielle Perrotti1, Lili Sadri1, Mikayla Fassler1
1Department of Surgery, Abington-Jefferson Health Hospital.
JSLS : Journal of the Society of Laparoendoscopic Surgeons
|August 25, 2020
Summary
Venous thromboembolism (VTE) prophylaxis after colorectal surgery showed varied prescriptions but negligible VTE rates. Further investigation into tailored prophylaxis for high-risk patients is recommended.
Area of Science:
- Colorectal Surgery
- Vascular Surgery
- Oncology
Background:
- Venous thromboembolisms (VTEs) increase morbidity and mortality in colorectal cancer patients.
- Current standard prophylaxis is 40 mg enoxaparin daily for 28 days.
- Prophylaxis variability and outcomes require examination.
Purpose of the Study:
- Examine variability in VTE prophylaxis discharge prescriptions post-colorectal surgery.
- Report 30-day postoperative VTE and bleeding incidence.
- Propose a new protocol for VTE prophylaxis.
Main Methods:
- Retrospective case series at Abington-Jefferson Health Hospital.
- Reviewed electronic medical records for colorectal cancer surgery patients (Oct 2019-Mar 2020).
- Recorded discharge prophylaxis, analyzed demographics, and measured 30-day postoperative VTE and bleeding rates.
Main Results:
- 18 of 57 patients received non-standard enoxaparin regimens.
- No VTEs occurred in any patients.
- Four patients experienced postoperative bleeding complications.
Conclusions:
- Significant variability exists in VTE prophylaxis prescriptions among colorectal surgery patients.
- VTE rates were negligible despite prescription variations.
- Tailored prophylaxis, potentially including aspirin 81 mg with enoxaparin 40 mg for high-risk patients, warrants further study.
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