Document Detail


Subcutaneous heparin versus low-molecular-weight heparin as thromboprophylaxis in patients undergoing colorectal surgery: results of the canadian colorectal DVT prophylaxis trial: a randomized, double-blind trial.
MedLine Citation:
PMID:  11224634     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the effectiveness and safety of low-dose unfractionated heparin and a low-molecular-weight heparin as prophylaxis against venous thromboembolism after colorectal surgery.
METHODS: In a multicenter, double-blind trial, patients undergoing resection of part or all of the colon or rectum were randomized to receive, by subcutaneous injection, either calcium heparin 5,000 units every 8 hours or enoxaparin 40 mg once daily (plus two additional saline injections). Deep vein thrombosis was assessed by routine bilateral contrast venography performed between postoperative day 5 and 9, or earlier if clinically suspected.
RESULTS: Nine hundred thirty-six randomized patients completed the protocol and had an adequate outcome assessment. The venous thromboembolism rates were the same in both groups. There were no deaths from pulmonary embolism or bleeding complications. Although the proportion of all bleeding events in the enoxaparin group was significantly greater than in the low-dose heparin group, the rates of major bleeding and reoperation for bleeding were not significantly different.
CONCLUSIONS: Both heparin 5,000 units subcutaneously every 8 hours and enoxaparin 40 mg subcutaneously once daily provide highly effective and safe prophylaxis for patients undergoing colorectal surgery. However, given the current differences in cost, prophylaxis with low-dose heparin remains the preferred method at present.
Authors:
R S McLeod; W H Geerts; K W Sniderman; C Greenwood; R C Gregoire; B M Taylor; R E Silverman; K G Atkinson; M Burnstein; J C Marshall; C J Burul; D R Anderson; T Ross; S R Wilson; P Barton;
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of surgery     Volume:  233     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-03-06     Completed Date:  2001-04-05     Revised Date:  2013-06-11    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  438-44     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University of Toronto, Toronto, Ontario, Canada. rmcleod@mtsinai.on.ca
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MeSH Terms
Descriptor/Qualifier:
Anticoagulants / therapeutic use*
Blood Loss, Surgical
Canada / epidemiology
Colectomy / methods*
Double-Blind Method
Enoxaparin / therapeutic use*
Female
Heparin / therapeutic use*
Humans
Injections, Subcutaneous
Intraoperative Complications / epidemiology,  prevention & control
Male
Middle Aged
Postoperative Complications / epidemiology,  prevention & control
Postoperative Hemorrhage / epidemiology
Prospective Studies
Rectum / surgery*
Thrombocytopenia / epidemiology,  etiology
Thromboembolism / epidemiology,  prevention & control
Venous Thrombosis / epidemiology,  prevention & control
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Enoxaparin; 37270-89-6/calcium heparin; 9005-49-6/Heparin
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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