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依诺肝素预防腹腔镜结直肠癌手术后静脉血栓栓塞事件的疗效和安全性:一项随机对照试验(YCOG1404)。

Efficacy and safety of enoxaparin for preventing venous thromboembolic events after laparoscopic colorectal cancer surgery: a randomized-controlled trial (YCOG 1404).

机构信息

Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.

Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, YokohamaYokohama, Kanagawa, 232-0024, Japan.

出版信息

Surg Today. 2020 Jan;50(1):68-75. doi: 10.1007/s00595-019-01859-w. Epub 2019 Aug 5.

Abstract

PURPOSE

We conducted a prospective study to evaluate the efficacy and safety of postoperative enoxaparin for the prevention of venous thromboembolism (VTE) after laparoscopic surgery for colorectal cancer (LAC) in Japanese patients.

METHODS

The subjects of this multicenter, open-label randomized-controlled trial were 121 patients who underwent LAC between September 2015 and May 2017. The patients were randomly allocated to receive intermittent pneumatic compression (IPC) with enoxaparin (20 mg, twice daily), started 24-36 h after surgery and continued until discharge (Enoxaparin group; n = 61), or IPC alone (IPC group; n = 60). The primary endpoint was the incidence of VTE on day 28 after surgery. The safety outcome was the incidence of any bleeding during treatment and follow-up.

RESULTS

The incidence of VTE on day 28 after surgery was 12.3% (7/57 patients) in the enoxaparin group and 11.9% (7/59 patients) in the IPC group ((p = 1.00). One of the 57 patients (1.8%) in the enoxaparin group and none in the IPC group experienced a bleeding event.

CONCLUSIONS

It may be unnecessary to give enoxaparin to all Japanese patients for the prevention of VTE after LAC. The UMIN Clinical Trials Registry number was UMIN000018633.

摘要

目的

我们进行了一项前瞻性研究,以评估在日本结直肠癌(LAC)腹腔镜手术后使用依诺肝素预防静脉血栓栓塞(VTE)的疗效和安全性。

方法

这项多中心、开放标签、随机对照试验的对象是 2015 年 9 月至 2017 年 5 月期间接受 LAC 的 121 名患者。患者被随机分配接受术后 24-36 小时开始的依诺肝素(20mg,每日两次)联合间歇性气动压缩(IPC)(依诺肝素组,n=61)或仅接受 IPC(IPC 组,n=60)。主要终点是术后第 28 天的 VTE 发生率。安全性结局是治疗和随访期间任何出血的发生率。

结果

依诺肝素组术后第 28 天 VTE 的发生率为 12.3%(57 例患者中有 7 例),IPC 组为 11.9%(59 例患者中有 7 例)(p=1.00)。依诺肝素组有 1 例(1.8%)患者发生出血事件,IPC 组无患者发生出血事件。

结论

对于预防 LAC 后 VTE,可能无需对所有日本患者使用依诺肝素。UMIN 临床试验注册编号为 UMIN000018633。

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