title: Thromboembolism prevention in surgery of digestive cancer.
abstract: BACKGROUND
  The venous thromboembolism is a common complication after surgical treatment in general and, in particular, on the therapeutic management on cancer. Surgery of the digestive tract has been reported to induce this complication. Patients with digestive cancer have substantial increased risk of initial or recurrent thromboembolism.
  
  
  OBJECTIVE
  To provide to surgeons working in digestive surgery and general surgery guidance on how to make safe thromboprophylaxis for patients requiring operations in the treatment of their gastrointestinal malignancies.
  
  
  METHODS
  The guideline was based on 15 relevant clinical issues and related to the risk factors, treatment and prognosis of the patient undergoing surgical treatment of cancer on digestive tract. They focused thromboembolic events associated with operations and thromboprophylaxis. The questions were structured using the PICO (Patient, Intervention or Indicator, Comparison and Outcome), allowing strategies to generate evidence on the main primary bases of scientific information (Medline / Pubmed, Embase, Lilacs / Scielo, Cochrane Library, PreMedline via OVID). Evidence manual search was also conducted (BDTD and IBICT). The evidence was recovered from the selected critical evaluation using discriminatory instruments (scores) according to the category of the question: risk, prognosis and therapy (JADAD Randomized Clinical Trials and New Castle Ottawa Scale for studies not randomized). After defining potential studies to support the recommendations, they were selected by the strength of evidence and grade of recommendation according to the classification of Oxford, including the available evidence of greater strength.
  
  
  RESULTS
  A total of 53,555 papers by title and / or abstract related to issue were found. Of this total were selected (1st selection) 478 studies that were evaluated as full-text. From them to support the recommendations were included in the consensus 132 papers. The 15 questions could be answered with evidence grade of articles with 31 A, 130 B, 1 C and 0 D.
  
  
  CONCLUSIONS
  It was possible to prepare safe recommendations as guidance for thromboembolism prophylaxis in operations on the digestive tract malignancies, addressing the most frequent topics of everyday work of digestive and general surgeons.
authors: Colégio Brasileiro de Cirurgia Digestiva, São Paulo, SP, Brazil. osvaldomalafaia@gmail.com
authors: Osvaldo
authors: O
authors: Malafaia
authors: Andre Luís
authors: AL
authors: Montagnini
authors: Angélica
authors: A
authors: Luchese
authors: Antonio Carlos
authors: AC
authors: Accetta
authors: Bruno
authors: B
authors: Zilberstein
authors: Carlos Alberto
authors: CA
authors: Malheiros
authors: Carlos Eduardo
authors: CE
authors: Jacob
authors: Claudemiro
authors: C
authors: Quireze-Junior
authors: Cláudio José Caldas
authors: CJ
authors: Bresciani
authors: Cleber Dario Pinto
authors: CD
authors: Kruel
authors: Ivan
authors: I
authors: Cecconello
authors: Eduardo Fonseca
authors: EF
authors: Sad
authors: Jorge Alberto Langbeck
authors: JA
authors: Ohana
authors: José Eduardo de
authors: JE
authors: Aguilar-Nascimento
authors: José Eduardo Ferreira
authors: JE
authors: Manso
authors: Jurandir Marcondes
authors: JM
authors: Ribas-Filho
authors: Marco Aurélio
authors: MA
authors: Santo
authors: Nelson Adami
authors: NA
authors: Andreollo
authors: Orlando Jorge Martins
authors: OJ
authors: Torres
authors: Paulo
authors: P
authors: Herman
authors: Ronaldo Mafia
authors: RM
authors: Cuenca
authors: Rubens Antônio Aissar
authors: RA
authors: Sallum
authors: Wanderley Marques
authors: WM
authors: Bernardo
mesh_terms: D005770:Gastrointestinal Neoplasms / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D013923:Thromboembolism / Q000517:prevention & control*