Effectiveness of prophylaxis for thromboembolic complications following anterior resection with total mesorectal excision for rectal cancer in male patients

Introduction: Thromboembolic complications are the most common morbidity in cancer patients, with 3-5 times increased incidence when compared to general surgery. Aim: The aim of this study was to assess the effectiveness of thromboembolism prophylaxis in male patients after anterior resection with total mesorectal excision for rectal carcinoma. Material and methods: Fifty males with RO resection were studied prospectively. For all cases mechanical and pharmacological methods for thromboembolism prevention were administered. Elastic stockings were used and enoxaparin 40 mg was given by subcutaneous injection twelve hours before surgery and once a day during the postoperative period, not less than five days. Results: TECs were noticed in 3 (6%) patients: all of them were over 40 years old, two received preoperative radiation, in two cases obesity was present, single patients had crural varices, mucinous cancer and the a history of thromboembolic episodes. Pulmonary embolism was not found, all TECs developed as deep vein thrombosis of lower extremity (in the distal part in two patients, in the proximal in one). In one patient TEC occurred during hospital stay, in two others after discharge. Despite optimal therapy thrombosis recurred in two patients with TECs. Conclusions: Thromboembolism prevention with mechanical and pharmacological methods effectively decreases the incidence of symptomatic TECs during the early postoperative period but they occur the most often after discharge from hospital. TECs are likely to develop recurrent episodes. Thus, prolonged prophylaxis may be needed, especially for patients with other risk factors of thrombosis.