Efficacy of postoperative anticoagulation therapy with enoxaparin for portal vein thrombosis after hepatic resection in patients with liver cancer

- We examine the effects of enoxaparin in 281 patients with hepatic resections.
- The rate of symptomatic pulmonary embolism was not significantly different.
- The rate of deep vein thrombosis was not significantly different.
- The rate of portal vein thrombosis (PVT) was significantly reduced by enoxaparin.
- Non-treatment with enoxaparin is independent risk factor for PVT (Odds ratio 2.49).

BackgroundsEnoxaparin, low-molecular-weight heparin, has become a routine thromboprophylaxis in general surgery.Study designA retrospective cohort study was performed in 281 patients who underwent hepatic resections for liver cancers from 2011 to 2013. These patients were divided into two groups; an enoxaparin (-) group (n = 228) and an enoxaparin (+) group (n = 53). Short-term surgical results including venous thromboembolism (VTE) and portal vein thrombosis (PVT) were compared.ResultsIn the enoxaparin (+) group, the patients' age (65 vs. 69 years; p = 0.01) and BMI (22.9 vs. 24.4; p < 0.01) were significantly higher. According to the symptomatic VTE, symptomatic pulmonary embolism occurred in one patient (0.4%) in the enoxaparin (-) group, but the complication rate was not significantly different (p = 0.63). The complication rate of PVT was significantly lower in the enoxaparin (+) group (10 vs. 2%; p = 0.04). The independent risk factors for PVT were an operation time ≥ 300 minutes (Odds ratio 6.66) and non-treatment with enoxaparin (Odds ratio 2.49).ConclusionsPostoperative anticoagulant therapy with enoxaparin could prevent PVT in patients who underwent hepatic resection for liver cancers.