Preoperative administration of LMW heparin safe in lung cancer patients: BMC

Venous thromboembolism remains a common but preventable complication for cancerous lung surgical patients. Current guidelines recommend thromboprophylaxis for lung patients at high risk of thrombosis, while a consensus about specific administration time is not reached. The current study was designed to investigate the safety profile of preoperative administration of low-molecular-weight-heparin (LMWH) for lung cancer patients. Researchers innovatively designed this study to testify whether preoperative administration of LMWH for lung cancer patients was safe and feasible.

From July 2017 to June 2018, patients prepared to undergo lung cancer surgery were randomly divided into the preoperative LMWH-administration group (PRL) for 4000 IU per day and the postoperative LMWH-administration group (POL) with same dosage, all the patients received thromboprophylaxis until discharge. Baseline characteristics including demographics and preoperative coagulation parameters were analyzed, while the endpoints included postoperative coagulation parameters, postoperative drainage data, hematologic data, intraoperative bleeding volume and reoperation rate.

Results highlighted the following facts.

• A total of 246 patients were collected in this RCT, 34 patients were excluded according to exclusion criterion, 101 patients were assigned to PRL group and 111 patients belonged to POL group for analysis finally.
• The baseline characteristic and preoperative coagulation parameters were all comparable except the PRL group cost more operation time (p = 0.008) and preoperative administration duration was significantly longer (p < 0.001).
• The endpoints including postoperative day 1 coagulation parameters, mean and total drainage volume, drainage duration, intraoperative bleeding volume and reoperation rate were all similar between the two groups.
• Moreover, coagulation parameters for postoperative day 3 between the two groups demonstrated no difference.

"Preoperative administration of LMWH for minimally invasive lung cancer surgery patients did demonstrate no significant effects on coagulation-related events compared with postoperative start of LMWH in this trial. The method is safe and feasible for lung cancer patients preparing to receive minimally invasive surgery. Absolutely, multicenter, prospective, randomized controlled trials are urgently needed to provide more strong evidence in the future."the team concluded.

For full article follow the link: https://doi.org/10.1186/s12893-021-01244-w

Primary source: BMC Surgery