Low molecular-weight heparin for thromboprophylaxis in patients undergoing gastric cancer surgery: an experience from one Korean institute.
OBJECTIVE
This study evaluated the efficacy for preventing venous thromboembolism (VTE) and adverse effects of low-molecular-weight heparin (LMWH) in order to launch a prospective clinical trial in Korea.


METHODS
We reviewed the medical records of 108 consecutive patients who underwent gastric cancer surgery. These patients were divided into 2 groups according to the type of thromboprophylaxis: group A, LMWH combined with intermittent pneumatic compression (IPC); group B, IPC alone. The postoperative outcomes of the two groups were compared.


RESULTS
Symptomatic VTE was observed in only 1 patient (0.9%) from group B. Postoperative bleeding was more common in group A than in group B (10.9% vs. 7.5%), although the difference was not significant (P = 0.055). Most bleeding episodes were minor and managed conservatively without intervention. Only a high body mass index was associated with a significantly increased risk of postoperative bleeding (odds ratio, 1.45; 95% confidence interval, 1.12-2.43; P = 0.051).


CONCLUSIONS
A 40 mg of enoxaparin sodium is a safe and feasible dose for prevention of VTE. With the results of this study, we are planning a prospective randomized clinical trial to investigate the clinical efficacy of LMWH thromboprophylaxis in gastric cancer patients in Korea.
Division of Gastrointestinal Surgery, Department of Surgery, The Catholic University of Korea School of Medicine, Seoul, Korea.
Sung Ho
SH
Choi
Division of Gastrointestinal Surgery, Department of Surgery, The Catholic University of Korea School of Medicine, Seoul, Korea.
Jung Ho
JH
Shim
Division of Gastrointestinal Surgery, Department of Surgery, The Catholic University of Korea School of Medicine, Seoul, Korea.
Cho Hyun
CH
Park
Division of Gastrointestinal Surgery, Department of Surgery, The Catholic University of Korea School of Medicine, Seoul, Korea.
Kyo Young
KY
Song
Feasibility; Korea; Low-molecular-weight heparin; Stomach cancer; Thromboembolism