Prolonged thromboprophylaxis with low molecular weight heparin after major abdominal surgery

PURPOSE OF REVIEW: To analyze the effect of prolonged thromboprophylaxis with low molecular weight heparin in patients undergoing major abdominal surgery. RECENT FINDINGS: Literature searches in PubMed, EMBASE and Cochrane Database between 1990 and 2006 were conducted to identify trials concerning prolonged thromboprophylaxis in major abdominal surgery. Three randomized controlled trials met the search criteria. They showed that low molecular weight heparin is effective and safe to use as prolonged thromboprophylaxis after major abdominal surgery. SUMMARY: Three published randomized studies all show a 50-60% relative risk reduction of late occurring deep venous thrombosis after major abdominal surgery. Evidence for the use of prolonged thromboprophylaxis after major abdominal surgery is emerging, and seems justified in selected high-risk patients, including patients operated on for cancer.