Original researchPneumatic compression versus low molecular weight heparin in gynecologic oncology surgery: a randomized trial☆
Section snippets
Materials and methods
All patients, over 40 years of age, admitted to the Gynecologic Oncology Service at Duke University Medical Center, undergoing major abdominal or pelvic surgery for known or suspected gynecologic malignancy, were offered participation in this study, which had been approved by the Institutional Review Board. Patients were ineligible for the following reasons: deep vein thrombosis or pulmonary embolism within the previous 6 months; contraindications to heparin therapy; conduction anesthesia;
Results
A total of 228 of 231 patients were entered into the study. Three patients declined participation before randomization. Twelve patients were excluded after randomization because their surgeries were cancelled. Four patients withdrew from the study before surgery. One additional patient was diagnosed with a symptomatic deep vein thrombosis preoperatively prompting exclusion. Using an intent-to-treat approach, 211 patients were randomized to receive either external pneumatic compression (106) or
Discussion
We have previously evaluated several methods of thromboembolism prophylaxis in an effort to identify the most effective modality associated with the least side effects in the prevention of postoperative thromboembolism among gynecologic oncology patients undergoing major surgery. A regimen of unfractionated heparin (5000 units SQ) given 2 hours preoperatively and Q 12 hours postoperatively was found to be ineffective in lowering the incidence of deep vein thrombosis in these high-risk patients.
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Supported in part by unrestricted educational grants from the Pharmacia Corporation and Venodyne, and the ACOG/Ethicon Research Award for Innovations in Gynecologic Surgery. These grants were used for research nurse salary and the expenses of sonographic studies.