Profilaxis de la enfermedad tromboembólica venosa en cirugía del cáncer

Zusammenfassung

The cancer is responsible for almost 20% of the new episodes of Venous Thromboembolism (VTE) in a community, and remains one of the most frequent complications in the oncologic patients. In these patients there are a number of specific factors that may attend as chemotherapy, hormonal treatment, type intervention or even the use of central venous catheters and the surgery itself, which carries a state of hypercoagulability that can persist at least one month after the surgery. Since the patients with cancer have a high risk of VTE, the clinical practice guides, such as the American College of Chest Physicians and the National Comprehensive Cancer Network, recommend the systematic use of thromboprophylaxis. In this paper, we review the recent literature and underline the update recommendations in the prevention of VTE events in cancer patients undergoing surgery. According to the medical evidence, the unfractionated heparin in low doses (currently in disuse), the low molecular weight heparins, and the fondaparinux reduce the risk of VTE with a low threat of bleeding (they are effectives and safes). The pharmacological prophylaxis should remain in these patients at least 4 weeks after the hospital discharge.