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Thromboprophylaxis

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The SAGES / ERAS® Society Manual of Enhanced Recovery Programs for Gastrointestinal Surgery

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Abstract

Postoperative venous thromboembolism (VTE) is a well-known and sometimes lethal complication, and prophylactic measures to decrease the risk have been documented in a vast number of publications. Today this is reflected in several guidelines (Guyatt et al., Chest 141(Suppl 2):7S–47S, 2012), and although there are some different views among surgeons, the majority of high-risk patients receive some form of prophylaxis today. When new surgical methods are introduced or old ones are modified, it would seem important to define the risk for various complications, VTE being one, and whether or not thromboprophylaxis should be used. A potential problem is to extrapolate routines without having data supporting the evidence. It is only a little more than a decade the principles of ERPs (enhanced or early recovery after surgery, also called fast-track programs or early recovery programs) were pioneered by Henrik Kehlet in Denmark. Since then these principles have been adopted in many types of surgery and nowadays, the patients are mobilized and sent home rapidly also after rather major surgical treatments. Intuitively this would decrease the risk for VTE. The aim of this chapter is to analyze the risk of VTE after ERP and the evidence on when and how to use thromboprophylaxis.

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References

  1. Guyatt GH, Akl EA, Crowther M, Gutterman DD, Schuunemann HJ, American College of Chest Physicians Antithrombotic T et al. Executive summary: antithrombotic therapy and prevention of thrombosis. 9th ed. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):7S–47S. PubMed Central PMCID: 3278060.

    Google Scholar 

  2. Neville A, Lee L, Antonescu I, Mayo NE, Vassiliou MC, Fried GM, et al. Systematic review of outcomes used to evaluate enhanced recovery after surgery. Br J Surg. 2014;101(3):159–70. PubMed.

    Article  CAS  PubMed  Google Scholar 

  3. Nicholson A, Lowe MC, Parker J, Lewis SR, Alderson P, Smith AF. Systematic review and meta-analysis of enhanced recovery programmes in surgical patients. Br J Surg. 2014;101(3):172–88. PubMed.

    Article  CAS  PubMed  Google Scholar 

  4. Lindberg F, Bergqvist D, Rasmussen I. Incidence of thromboembolic complications after laparoscopic cholecystectomy: review of the literature. Surg Laparosc Endosc. 1997;7(4):324–31.

    Article  CAS  PubMed  Google Scholar 

  5. Rondelli F, Manina G, Agnelli G, Becattini C. Venous thromboembolism after laparoscopic cholecystectomy: clinical burden and prevention. Surg Endosc. 2013;27(6):1860–4. PubMed.

    Article  PubMed  Google Scholar 

  6. Schwenk W, Bohm B, Fugener A, Muller JM. Intermittent pneumatic sequential compression (ISC) of the lower extremities prevents venous stasis during laparoscopic cholecystectomy. A prospective randomized study. Surg Endosc. 1998;12(1):7–11.

    Article  CAS  PubMed  Google Scholar 

  7. Husted H, Otte KS, Kristensen BB, Orsnes T, Wong C, Kehlet H. Low risk of thromboembolic complications after fast-track hip and knee arthroplasty. Acta Orthop. 2010;81(5):599–605. PubMed Central PMCID: 3214750.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Jorgensen CC, Jacobsen MK, Soeballe K, Hansen TB, Husted H, Kjaersgaard-Andersen P, et al. Thromboprophylaxis only during hospitalisation in fast-track hip and knee arthroplasty, a prospective cohort study. BMJ Open. 2013;3(12):e003965. PubMed Central PMCID: 3863129.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Malviya A, Martin K, Harper I, Muller SD, Emmerson KP, Partington PF, et al. Enhanced recovery program for hip and knee replacement reduces death rate. Acta Orthop. 2011;82(5):577–81. PubMed Central PMCID: 3242954.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Stottmeier S, Harling H, Wille-Jorgensen P, Balleby L, Kehlet H. Pathogenesis of morbidity after fast-track laparoscopic colonic cancer surgery. Colorectal Dis. 2011;13(5):500–5. PubMed.

    Article  CAS  PubMed  Google Scholar 

  11. Xing KH, Morrison G, Lim W, Douketis J, Odueyungbo A, Crowther M. Has the incidence of deep vein thrombosis in patients undergoing total hip/knee arthroplasty changed over time? A systematic review of randomized controlled trials. Thromb Res. 2008;123(1):24–34. PubMed.

    Article  CAS  PubMed  Google Scholar 

  12. Pearse EO, Caldwell BF, Lockwood RJ, Hollard J. Early mobilisation after conventional knee replacement may reduce the risk of postoperative venous thromboembolism. J Bone Joint Surg Br. 2007;89(3):316–22. PubMed.

    Article  CAS  PubMed  Google Scholar 

  13. McDonald DA, Siegmeth R, Deakin AH, Kinninmonth AW, Scott NB. An enhanced recovery programme for primary total knee arthroplasty in the United Kingdom – follow up at one year. Knee. 2012;19(5):525–9. PubMed.

    Article  CAS  PubMed  Google Scholar 

  14. Lassen K, Soop M, Nygren J, Cox PB, Hendry PO, Spies C, et al. Consensus review of optimal perioperative care in colorectal surgery: Enhanced Recovery After Surgery (ERAS) Group recommendations. Arch Surg. 2009;144(10):961–9. PubMed.

    Article  PubMed  Google Scholar 

  15. Nygren J, Thacker J, Carli F, Fearon KC, Norderval S, Lobo DN, et al. Guidelines for perioperative care in elective rectal/pelvic surgery: Enhanced Recovery After Surgery (ERAS((R))) Society recommendations. World J Surg. 2013;37(2):285–305. PubMed.

    Article  CAS  PubMed  Google Scholar 

  16. Lassen K, Coolsen MM, Slim K, Carli F, de Aguilar-Nascimento JE, Schafer M, et al. Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS(R)) Society recommendations. World J Surg. 2013;37(2):240–58. PubMed.

    Article  PubMed  Google Scholar 

  17. Cerantola Y, Valerio M, Persson B, Jichlinski P, Ljungqvist O, Hubner M, et al. Guidelines for perioperative care after radical cystectomy for bladder cancer: Enhanced Recovery After Surgery (ERAS((R))) society recommendations. Clin Nutr. 2013;32(6):879–87. PubMed.

    Article  PubMed  Google Scholar 

  18. Patel HR, Cerantola Y, Valerio M, Persson B, Jichlinski P, Ljungqvist O, et al. Enhanced recovery after surgery: are we ready, and can we afford not to implement these pathways for patients undergoing radical cystectomy? Eur Urol. 2014;65(2):263–6. PubMed.

    Article  PubMed  Google Scholar 

  19. Hill J, Treasure T, Guideline Development Group. Reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to hospital: summary of the NICE guideline. Heart. 2010;96(11):879–82. PubMed.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden

    David Bergqvist M.D.

Authors
  1. David Bergqvist M.D.
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Correspondence to David Bergqvist M.D. .

Editor information

Editors and Affiliations

  1. Division of General Surgery Steinberg-Bernstein Chair in Minimally Invasive Surgery and Innovation, McGill University, Health Centre, Montreal, Québec, Canada

    Liane S. Feldman

  2. Division of Colorectal Surgery, Department of Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, USA

    Conor P. Delaney

  3. Faculty of Medicine and Health School of Health and Medical Sciences, Department of Surgery Örebro University Örebro; Affiliated Professor of Surgery Metabolism and Nutrition, Karolinska Institute, Stockholm, Sweden

    Olle Ljungqvist

  4. Department of Anesthesia, Montreal General Hospital, McGill University, Montreal, Québec, Canada

    Francesco Carli

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© 2015 Springer International Publishing Switzerland

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Bergqvist, D. (2015). Thromboprophylaxis. In: Feldman, L., Delaney, C., Ljungqvist, O., Carli, F. (eds) The SAGES / ERAS® Society Manual of Enhanced Recovery Programs for Gastrointestinal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-20364-5_9

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  • DOI: https://doi.org/10.1007/978-3-319-20364-5_9

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-20363-8

  • Online ISBN: 978-3-319-20364-5

  • eBook Packages: MedicineMedicine (R0)

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