PMID- 15286956
OWN - NLM
STAT- MEDLINE
DCOM- 20040824
LR  - 20071115
IS  - 0007-1323 (Print)
IS  - 0007-1323 (Linking)
VI  - 91
IP  - 8
DP  - 2004 Aug
TI  - Low molecular weight heparin for the prevention of venous thromboembolism after 
      abdominal surgery.
PG  - 965-74
AB  - BACKGROUND: Abdominal surgery carries a significant risk of venous thrombosis, a 
      risk further increased in patients with cancer. METHODS: Embase and Pubmed 
      searches between 1980 and 2003, using the key words 'heparin,' 'surgery,' 
      'abdominal or rectal or colorectal or rectum or colon' and 'clinical trial', were 
      conducted to identify studies of thromboprophylaxis in patients having abdominal 
      surgery. RESULTS: A total of 16 comparative studies were identified. These show 
      that low molecular weight heparin (LMWH) is as effective as unfractionated 
      heparin (UFH) in reducing venous thromboembolism after abdominal surgery and, at 
      appropriate doses, can reduce bleeding complications. In very high-risk patients, 
      a higher dose of LMWH may offer increased efficacy without increasing bleeding 
      risk. Extending the standard 7-10-day period of prophylaxis may benefit certain 
      high-risk groups; recent data show a significant benefit of 4-week enoxaparin 
      thromboprophylaxis compared with a standard regimen, at no cost to safety. 
      CONCLUSION: Patients undergoing abdominal surgery should be stratified according 
      to thromboembolism risk and managed accordingly. LMWH is a recommended 
      alternative to UFH in moderate- or high-risk patients. In patients with cancer, 
      high doses of LMWH may offer increased efficacy without increasing the bleeding 
      risk and an extended 4-week period of prophylaxis appears beneficial.
CI  - Copyright 2004 British Journal of Surgery Society Ltd.
FAU - Bergqvist, D
AU  - Bergqvist D
AD  - Department of Surgery, University Hospital, SE-751 85 Uppsala, Sweden. 
      david.bergqvist@kirugi.uu.se
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - England
TA  - Br J Surg
JT  - The British journal of surgery
JID - 0372553
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Abdomen/*surgery
MH  - Anticoagulants/*therapeutic use
MH  - Colon/surgery
MH  - Dose-Response Relationship, Drug
MH  - Double-Blind Method
MH  - Heparin, Low-Molecular-Weight/*therapeutic use
MH  - Humans
MH  - Meta-Analysis as Topic
MH  - Postoperative Complications/*prevention & control
MH  - Randomized Controlled Trials as Topic
MH  - Rectum/surgery
MH  - Risk Factors
MH  - Thromboembolism/*prevention & control
MH  - Treatment Outcome
MH  - Venous Thrombosis/*prevention & control
RF  - 46
EDAT- 2004/08/03 05:00
MHDA- 2004/08/25 05:00
CRDT- 2004/08/03 05:00
PHST- 2004/08/03 05:00 [pubmed]
PHST- 2004/08/25 05:00 [medline]
PHST- 2004/08/03 05:00 [entrez]
AID - 10.1002/bjs.4639 [doi]
PST - ppublish
SO  - Br J Surg. 2004 Aug;91(8):965-74. doi: 10.1002/bjs.4639.