“General surgical patients who undergo major operations are at risk of venous thromboembolism (VTE). This incurs significant morbidity and healthcare costs. Therefore, the Royal Australasian College of Surgeons and other regulatory bodies recommend routine thromboprophylaxis. Moreover, considerations for thromboprophylaxis is an integral part of theatre timeout performed prior to any operation.”

“In this study, we extend the observations made from our multicentre survey by quantifying the heterogeneity of perioperative thromboprophylaxis across all major general surgical operations, and placing them in context of their bleeding and VTE risk. Findings from this study will highlight areas of practice with the greatest variability, allow surgeons to benchmark their practices against that of their colleagues and focus future research to optimize perioperative thromboprophylaxis.”

“In this study, extended chemoprophylaxis was mainly restricted to patients undergoing weight loss surgery and gastrointestinal cancer resections. However, <50% of cancer patients and <10% of bariatric patients were prescribed extended chemoprophylaxis. This is
despite recent meta-analyses demonstrating its safety and efficacy after abdominopelvic surgery for malignant and benign diseases. Furthermore, there is mounting evidence supporting its use after bariatric, liver and pancreas surgeries.Therefore, it is imperative that consensus guidelines are continually revised to reflect the latest research developments.”

Liu, David S et al. “Variations in practice of thromboprophylaxis across general surgical subspecialties: a multicentre (PROTECTinG) study of elective major surgeries.” ANZ journal of surgery vol. 90,12 (2020): 2441-2448. Free Full Text