Key result
Enoxaparin cuts DVT by an absolute ~23% vs intermittent pneumatic compression in esophagectomy patients.
Why the study?
The efficacy and safety of low-molecular-weight heparin for preventing postoperative venous thromboembolism after esophagectomy were not established.
Does enoxaparin prevent postoperative venous thromboembolism in patients with esophageal cancer undergoing esophagectomy?
RCT (n=73)
randomized
No
Does enoxaparin prevent postoperative venous thromboembolism in patients with esophageal cancer undergoing esophagectomy?
Enoxaparin significantly reduces the incidence of postoperative deep vein thrombosis compared to intermittent pneumatic compression in patients undergoing esophagectomy.
Supports enoxaparin over intermittent pneumatic compression for postoperative DVT prevention after esophagectomy; extends RCT evidence for pharmacologic VTE prophylaxis in esophageal cancer surgery.
BACKGROUND/AIM: This study aimed to assess whether low-molecular-weight heparin (LMWH) is effective and safe in preventing postoperative venous thromboembolism (VTE) in patients undergoing esophageal cancer surgery. PATIENTS AND METHODS: In this single-institution, prospective, randomized trial, 73 patients with esophageal cancer undergoing esophagectomy were randomly divided into the enoxaparin group (E group) and intermittent pneumatic compression group (I group). The primary endpoint was efficacy of enoxaparin, and secondary endpoints were evidence of bleeding and serum anti-Xa activity in the E group. RESULTS: The E group comprised 42 patients and the I group comprised 31 patients. Deep vein thrombosis was observed in 0 (0%) patients in the E group and 7 (22.6%) patients in the I group (p=0.002). Soluble fibrin monomer complex was significantly lower in the E versus I group on day 8 (p<0.001). D-dimer was significantly lower in the E versus I group on days 2, 8, and 15 (p=0.008, p<0.001, p<0.001, respectively). CONCLUSION: VTE was significantly reduced by using enoxaparin.
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Tanaka et al. (2019) conducted an RCT in esophageal cancer (n=73). enoxaparin vs. intermittent pneumatic compression was evaluated on efficacy of enoxaparin (deep vein thrombosis) (p=0.002). Enoxaparin significantly reduced deep vein thrombosis compared to intermittent pneumatic compression (0% vs 22.6%; p=0.002) in patients undergoing esophagectomy.
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