Kim BJ, et al. – For the prevention of venous thromboembolism (VTE), this study tried to compute the safety and efficacy of extended pharmacologic thromboprophylaxis in liver surgery. This study highlighted the safety and efficacy of extended pharmacologic thromboprophylaxis for liver surgery patients.

Methods

• 124 patients who underwent liver resection for malignancy were placed on an extended pharmacologic thromboprophylaxis protocol, from August 2013 to April 2015.
• Thrombo-Embolic Deterrent hose and sequential compression devices were included in intraoperative VTE prophylaxis.
• Daily anticoagulant VTE prophylaxis was initiated for the hospitalization, once hemostasis was assured following hepatectomy.
• Moreover, after hospital discharge, the large majority of patients (114, 91.9%) continued anticoagulant thromboprophylaxis (enoxaparin) to complete a total course of 14 days after minor/minimally invasive (MIS) hepatectomy or 28 days after major hepatectomy or a history of VTE.

Results

• 39 (31.2%) major hepatectomies and 38 (31.5%) MIS approaches were incorporated in the cohort.
• 5.6%, 8.1% and 10.5% were the intraoperative, postoperative and overall transfusion rates.
• For 40 (32.3%) patients, pharmacologic thromboprophylaxis was started on postoperative day (POD) 0 and POD 1 for 84 (67.7%) patients.
• No postoperative symptomatic DVT or pulmonary embolic events were diagnosed, during 90-days of follow-up.
• No pulmonary emboli, other thoracic, splanchnic, or ileofemoral vein thromboses were determined by standard protocol computed tomography scans of the chest/abdomen/pelvis that were obtained on 112 (90.3%) study patients.
• Requiring neither blood transfusion nor reoperation, two (1.6%) patients had minor bleeding events that resolved after discontinuation of enoxaparin.
• With no 90-day mortalities, the severe complication rate was 5.6%.