Thromboembolic prophylaxis as a risk factor for postoperative complications after breast cancer surgery.
Hematoma and bruising (sugillation) are frequent problems after operations for primary breast cancer. In the present study we evaluated the influence of various methods of perioperative thromboembolic prophylaxis on the postoperative incidence of hematoma and suggilation. From June 1994 through August 1996, a series of 425 patients consecutively operated on for primary breast cancer were included. Thromboembolic prophylaxis was low-molecular-weight heparin (LMWH) in 310 patients and thigh-long graded compression (TED) stockings in 102 patients. Postoperative complications including deep vein thrombosis, pulmonary embolism, wound hematoma, and sugillation were recorded, and 17 variables with a potential influence on complications were analyzed by logistic regression analysis. Heparin prophylaxis compared to prophylaxis with TED stockings was significantly and independently associated with postoperative hematoma [odds ratio (OR) 3, 13; 95% confidence interval (CI) 1.38-7.13] or sugillation (OR 3.34; 95% CI 1.93-5.78). No clinically overt thromboembolic complications were diagnosed. After operations for breast cancer we found that LMWH was significantly associated with postoperative hematoma and sugillation compared to TED stockings for perioperative thromboembolic prophylaxis.
Friis
Esbern
E
Department of Surgical Gastroenterology K, H:S Bispebjerg University Hospital, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark. rh03084@rh.dk
Hørby
John
J
Sørensen
Lars Tue
LT
Pilsgaard
Bo
B
Wille-Jørgensen
Peer
P
Johansen
Lars
L
Jørgensen
Torben
T
D000925:Anticoagulants / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000601:surgery*; D003288:Contusions / Q000517:prevention & control; D005260:Female; D006406:Hematoma / Q000209:etiology*; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects*; D006801:Humans; D016015:Logistic Models; D011183:Postoperative Complications / Q000517:prevention & control*; D012307:Risk Factors; D020246:Venous Thrombosis / Q000517:prevention & control*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight