Zhang Ying, Zhou Xiaozhu, Wu Yi, Chen Shicai, Cui Xiangli, Zhao Ying
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Department of Pharmacy, Beijing Luhe Hospital, Capital Medical University, Beijing, China.
Drugs Real World Outcomes. 2025 Aug 5. doi: 10.1007/s40801-025-00510-0.
The optimal duration for thromboprophylaxis after colorectal cancer surgery remains uncertain. We sought to compare the effectiveness and safety of long-term thromboprophylaxis to that of short-term thromboprophylaxis in preventing venous thromboembolism (VTE) after colorectal cancer surgery.
In our retrospective study, patients undergoing colorectal cancer surgery were divided into the short-term (< 7 days) and long-term (≥ 7 days) thromboprophylaxis groups based on the low molecular weight heparin prophylaxis regimen. Propensity score matching was performed for both groups, and comparative analysis of the incidence of asymptomatic or symptomatic VTE and bleeding complications was conducted. Multivariable logistic regression analysis was performed in the unmatched cohort to explore the association of potential risk factors with postoperative VTE.
A total of 140 patients undergoing colorectal cancer surgery were included. After matching, there were 57 patients in each group. VTE occurred in 18 patients (15.8%) within 6 months after surgery, with 12 cases (21.1%) in the short-term thromboprophylaxis group and six cases (10.5%) in the long-term thromboprophylaxis group (P = 0.123). There were no significant differences in the incidence of bleeding complications between the two groups. Multivariable logistic regression analysis indicated that long-term thromboprophylaxis can reduce the risk of postoperative VTE (odds ratio 0.34, 95% confidence interval 0.12-0.95; P = 0.039).
Long-term thromboprophylaxis (≥ 7 days) demonstrated comparable effectiveness and safety to shorter regimens (< 7 days) in preventing postoperative VTE in patients with colorectal cancer, while suggesting potential sustained protective benefits during extended follow-up periods exceeding 6 months. Whether VTE prophylaxis should be extended to 28 days post-surgery requires further research.
结直肠癌手术后血栓预防的最佳持续时间仍不确定。我们试图比较长期血栓预防与短期血栓预防在预防结直肠癌手术后静脉血栓栓塞（VTE）方面的有效性和安全性。
在我们的回顾性研究中，根据低分子量肝素预防方案，将接受结直肠癌手术的患者分为短期（<7天）和长期（≥7天）血栓预防组。对两组进行倾向评分匹配，并对无症状或有症状的VTE和出血并发症的发生率进行比较分析。在未匹配的队列中进行多变量逻辑回归分析，以探讨潜在危险因素与术后VTE的关联。
共纳入140例接受结直肠癌手术的患者。匹配后，每组有57例患者。18例患者（15.8%）在术后6个月内发生VTE，短期血栓预防组有12例（21.1%），长期血栓预防组有6例（10.5%）（P = 0.123）。两组出血并发症的发生率无显著差异。多变量逻辑回归分析表明，长期血栓预防可降低术后VTE的风险（比值比0.34，95%置信区间0.12 - 0.95；P = 0.039）。
长期血栓预防（≥7天）在预防结直肠癌患者术后VTE方面显示出与较短方案（<7天）相当的有效性和安全性，同时表明在超过6个月的延长随访期内可能有持续的保护益处。VTE预防是否应延长至术后28天需要进一步研究。
