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Intermittent pneumatic compression versus additional prophylaxis with enoxaparin for prevention of venous thromboembolism after laparoscopic surgery for gastric and colorectal malignancies : multicentre randomized clinical trial

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Title: Intermittent pneumatic compression versus additional prophylaxis with enoxaparin for prevention of venous thromboembolism after laparoscopic surgery for gastric and colorectal malignancies : multicentre randomized clinical trial
Authors: Kamachi, H. Browse this author →KAKEN DB
Homma, S. Browse this author
Kawamura, H. Browse this author
Yoshida, T. Browse this author
Ohno, Y. Browse this author
Ichikawa, N. Browse this author
Yokota, R. Browse this author
Funakoshi, T. Browse this author
Maeda, Y. Browse this author
Takahashi, N. Browse this author
Amano, T. Browse this author
Taketomi, A. Browse this author →KAKEN DB
Issue Date: Oct-2020
Publisher: John Wiley & Sons
Journal Title: BJS Open
Volume: 4
Issue: 5
Start Page: 804
End Page: 810
Publisher DOI: 10.1002/bjs5.50323
Abstract: Background: The role of antithrombotic chemoprophylaxis in prevention of venous thromboembolism (VTE) in laparoscopic surgery for gastric and colorectal malignancies is unknown. This study compared the addition of enoxaparin following intermittent pneumatic compression (IPC) with IPC alone in patients undergoing laparoscopic surgery for gastrointestinal malignancy. Methods: In this multicentre RCT, eligible patients were older than 40 years and had a WHO performance status of 0 or 1. Exclusion criteria were prescription of antiplatelet or anticoagulant drugs and history of VTE. Patients were allocated to IPC or to ICP with enoxaparin in a 1 : 1 ratio. Stratification factors included sex, location of cancer, age 61 years and over, and institution. Enoxaparin was administered on days 1-7 after surgery. Primary outcome was VTE, evaluated by multidetector CT on day 7. Results: Of 448 patients randomized, 208 in the IPC group and 182 in the IPC with enoxaparin group were evaluated. VTE occurred in ten patients (4.8 per cent) in the IPC group and six (3.3 per cent) in the IPC with enoxaparin group (P = 0.453). Proximal deep vein thrombosis and/or pulmonary embolism occurred in seven patients (3.4 per cent) in the IPC group and one patient (0.5 per cent) in the IPC with enoxaparin group (P = 0.050). All VTE events were asymptomatic and non-fatal. Bleeding occurred in 11 of 202 patients in the IPC with enoxaparin group, and one patient needed a transfusion. All bleeding events were managed by discontinuation of the drug. Conclusion: IPC with enoxaparin after laparoscopic surgery for gastric and colorectal malignancies did not reduce the rate of VTE.
Rights: http://creativecommons.org/licenses/by/4.0/
Type: article
URI: http://hdl.handle.net/2115/79628
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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