Pharmacological Thromboprophylaxis in Abdominal and Pelvic Surgery

Abstract

  The mechanical prophylaxis for venous thromboembolism (VTE) has been widely performed for the last 5 years. However, the mortality of perioperative pulmonary thromboembolism (PTE) is still extremely high, suggesting the necessity of pharmacological thromboprophylaxis. Under these circumstances, the reimbursement of anticoagulants like enoxaparin (low molecular weight heparin) and fondaparinux for perioperative thromboprophylaxis has recently become applicable in Japan, and the same pharmacological thromboprophylaxis can be performed as in western countries.
  In Japanese clinical trials, the beneficial effect on VTE was confirmed in both enoxaparin and fondaparinux without increased risk of bleeding. The current status of thromboprophylaxis in abdominal surgery is discussed focusing mainly on the clinical results of both anticoagulants.