Review Article

Venous Thromboembolism in Cancer Patients Undergoing Major Abdominal Surgery: Prevention and Management

Table 2

Studies evaluating venous thromboembolism (VTE) prophylaxis with LMWH and UFH in cancer patients undergoing major abdominal surgery.

TrialMethodPatients ( 𝑛 )Study populationRegimenFollowupIncidence of VTE
StudyControlStudy (%)Control (%)

Bergqvist et al. 1990 [246]Randomise double blind-trial637Patients with cancer (study subgroup) undergoing abdominal surgeryDalteparin 5000 Units preoperatively then q.d. × 5–8 daysUFH 5000 Units 2 h preoperatively then b.d. × 5–8 days7 days6.411.2
EFS 1988 [120]Randomised trial704Patients with cancer (study subgroup) scheduled for elective abdominal surgeryFraxiparin 7500 anti-Xa units preoperatively then q.d. × 7 days Calcium heparin 5000 units preoperatively then t.i.d × 7 days7 days
Enoxacan 1997 [229]Double-blind randomised trial631Patients undergoing planned curative abdominal or pelvic surgery for cancer (study subgroup)Enoxaparin 40 mg q.d. × 10 daysLow-dose UFH t.i.d × 10 days3 months14.718.2
Fricker et al. 1988 [247]Randomised trial80Patients with cancer undergoing surgery for abdominal and pelvic malignancy2500 anti-Xa Units 2 h before surgery and 12 h after the first injection and then 5000 anti-Xa Units fragmin injection q.d. × 10 days5000 IU of calcium heparin injection 2 h before the surgery and then t.i.d × 10 days10 days55
Godwin et al. 1993 [248]Double-blind randomised trial904Patients undergoing abdominal or pelvic cancer surgeryRDH (Normiflo) 50 U 2 h preoperatively and then 90 U q.d./bdUFH 5000 U 2 h preoperatively and then 5000 U b.d.
McLeod et al. 2001 [249]Randomise double-blind trial324Patients with cancer undergoing colorectal cancer surgeryEnoxaparin 40 mg q.d. × 10 daysHeparin 5000 U t.i.d. × 10 days10 days 13.916.9
Onarheim et al. 1986 [250]Randomised double-blind trial52Patients undergoing surgery for abdominal malignancyDalteparin 5000 U 2 h preoperatively then q.d. × 6 daysHeparin Kabi2165 5000 U 2 h preoperatively then b.d. × 6 days7 days1.923.84

VTE: venous thromboembolism, LMWH: low molecular weight heparin, UFH: unfractionated heparin, sc: subcutaneous.