title: Safety of thromboprophylaxis after oncologic head and neck surgery. Study of 1018 patients.
abstract: BACKGROUND
  Deep venous thrombosis (DVT) and pulmonary embolism (PE) are significantly reduced with appropriate use of thromboprophylaxis and scarcely evaluated in patients undergoing oncologic head and neck surgery (OHNS).
  
  
  METHODS
  A retrospective study on 1018 patients who underwent oncologic head and neck surgery. The records of patients with venous thromboembolism (VTE) or postoperative bleeding were reviewed for the cancer grading, management, previous known coagulopathy, anticoagulation, and general demographics.
  
  
  RESULTS
  Of a total of 1018 patients undergoing oncologic head and neck surgery, 450 patients had no chemoprophylaxis and 568 received it. The rate of a VTE event in our cohort was 0%. Twelve patients presented with hematoma or bleeding from the surgical site, 11 in the group that received chemoprophylaxis (p = .006).
  
  
  CONCLUSIONS
  Our analysis shows no benefit from chemoprophylaxis in oncologic head and neck surgery patients, with no VTE events. Our analysis shows higher rates of morbid side effects from using chemoprophylaxis, and we therefore conclude that chemoprophylaxis should not be routinely used.
authors.affiliation: Department of Surgical Oncology, Peter MacCallum Cancer Institute, Melbourne, Australia.
authors.forename: Haim
authors.initials: H
authors.lastname: Gavriel
authors.forename: Evan
authors.initials: E
authors.lastname: Thompson
authors.forename: Stephen
authors.initials: S
authors.lastname: Kleid
authors.forename: SorWay
authors.initials: S
authors.lastname: Chan
authors.forename: Andrew
authors.initials: A
authors.lastname: Sizeland
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D037981:Neck Dissection / Q000009:adverse effects* / Q000379:methods; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology; D011300:Preoperative Care / Q000379:methods; D011322:Primary Prevention / Q000379:methods; D011655:Pulmonary Embolism / Q000209:etiology / Q000473:pathology*; D012189:Retrospective Studies; D018570:Risk Assessment; D017751:Safety Management; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants