A randomized trial of low-dose heparin and intermittent pneumatic calf compression for the prevention of deep venous thrombosis after gynecologic oncology surgery.
OBJECTIVE
Our aim was to determine the relative efficacy and complications of low-dose heparin and intermittent pneumatic calf compression for the prevention of postoperative venous thrombosis in patients undergoing surgery for gynecologic malignancy.


METHODS
Randomized trial comparing 107 patients treated with low-dose heparin to 101 patients treated with intermittent pneumatic calf compression was performed. All patients were evaluated with iodine-125 fibrinogen scanning of the legs. Clinical and laboratory variables associated with bleeding complications were recorded prospectively.


RESULTS
Venous thrombosis was diagnosed in seven patients receiving low-dose heparin and in four receiving intermittent pneumatic calf compression (p = 0.54). Low-dose heparin patients received more blood transfusions postoperatively (p = 0.02), had increased volume of retroperitoneal drainage (p = 0.02), and the activated partial thromboplastin time was more frequently prolonged (p = 0.001).


CONCLUSIONS
Low-dose heparin and intermittent pneumatic calf compression provide similar reduction in reducing the incidence of postoperative venous thrombosis. However, low-dose heparin is more frequently associated with postoperative bleeding complications.
Clarke-Pearson
D L
DL
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710.
Synan
I S
IS
Dodge
R
R
Soper
J T
JT
Berchuck
A
A
Coleman
R E
RE
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D005676:Gravity Suits; D006470:Hemorrhage / Q000209:etiology; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*
D006493:Heparin