American Society of Hirudotherapy

Practice patterns for deep vein thrombosis prophylaxis in minimal-access surgery

Research article published in Canadian journal of surgery. Journal canadien de chirurgie (2006)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Observational studyClinical TrialsBeekman R et al. · Canadian journal of surgery. Journal canadien de chirurgie, 2006

Abstract

BACKGROUND: There are no comprehensive evidence-based guidelines for deep vein thrombosis (DVT) prophylaxis in patients undergoing minimal-access surgery (MAS). METHODS: We completed a cross-sectional survey of general surgeons practising in Ontario, in order to establish current practice patterns for DVT prophylaxis for MAS procedures. RESULTS: The mean duration of practice of respondents was 15.4 years, with most (67.0%) practising outside an academic centre. For minor MAS, most surgeons do not give DVT prophylaxis (73.8% in laparoscopic cholecystectomy and 63.7% in laparoscopic inguinal hernia repair). For major MAS, a minority of surgeons do not give DVT prophylaxis (4.1% in laparoscopic colorectal surgery and 13.6% in laparoscopic splenectomy). However, there remains considerable variation in the mechanism (pharmacological, mechanical), approach and duration (perioperative, postoperative) of DVT prophylaxis among respondents in all case scenarios evaluated. Academic surgeons and surgeons in practice for 15 years or less are more aggressive with preoperative heparin administration. CONCLUSIONS: There is substantial and important variability in the current practice of general surgeons with respect to DVT prophylaxis for MAS. Considerable benefit will be derived from clinical trials that provide data to establish appropriate DVT prophylaxis guidelines for MAS. CONTEXTE: Il n'existe pas de guides factuels détaillés sur la prophylaxie contre la thrombose veineuse profonde (TVP) chez les patients qui subissent une intervention chirurgicale à effraction minimale (CEM). MÉTHODES: Nous avons réalisé un sondage transversal auprès des chirurgiens généraux pratiquant en Ontario afin de déterminer les tendances courantes de la pratique en ce qui a trait à la prophylaxie contre la TVP pour des interventions de CEM. RÉSULTATS: Les répondants pratiquent en moyenne depuis 15,4 ans et la plupart (67,0 %) pratiquent en dehors d'un centre universitaire. Dans le cas des CEM mineures, la plupart des chirurgiens n'administrent pas de prophylaxie contre la TVP (73,8 % dans les cas de cholécystectomie par laparoscopie et 63,7 % dans les cas de réparation de hernie inguinale par laparoscopie). Pour les CEM majeures, une minorité de chirurgiens n'administrent pas de prophylaxie contre la TVP (4,1 % dans les cas de chirurgie colorectale par laparoscopie et 13,6 % pour la splénectomie par laparoscopie). Le mécanisme (pharmacologique, mécanique), l'approche et la durée (périopératoire, postopératoire) de la prophylaxie contre la TVP varient toutefois considérablement chez les répondants dans tous les scénarios évalués. Les chirurgiens universitaires et ceux qui pratiquent depuis 15 ans ou moins adoptent une démarche d'intervention plus directe en administrant de l'héparine préopératoire. CONCLUSION: La pratique courante chez les chirurgiens généraux en ce qui a trait à la prophylaxie contre la TVP dans des cas de CEM varie considérablement. Il serait très avantageux de procéder à des études cliniques qui produiraient des données permettant d'établir des guides appropriés sur la prophylaxie contre la TVP dans les cas de CEM.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeComparative StudyJournal ArticleResearch Support, Non-U.S. Gov't
Indexed MeSH termsFollow-Up StudiesHumansIncidenceIntraoperative ComplicationsLaparoscopyOntarioPractice Patterns, Physicians'Surveys and QuestionnairesVenous Thrombosis

Summary

Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.

Why This Matters for Hirudotherapy

This cross-sectional survey of general surgeons in Ontario examined deep-vein-thrombosis prophylaxis practice in minimal-access surgery, finding that most surgeons omit prophylaxis for minor procedures (e.g., 73.8% in laparoscopic cholecystectomy) but use it for major ones, with substantial variation in method, timing, and duration, and concluding that the lack of evidence-based guidelines warrants clinical trials. Its relevance to hirudotherapy is only distant and contextual: it concerns the broader landscape of venous-thromboembolism prevention and anticoagulant use, the therapeutic territory that leech-derived thrombin inhibitors relate to, but it deals with conventional pharmacologic and mechanical prophylaxis. The honest caveat is that this is a survey of self-reported physician behavior, not a study of any treatment or of leeches, so it carries no direct evidence for hirudotherapy and is best regarded as peripheral background on anticoagulation practice.

Citation

Practice patterns for deep vein thrombosis prophylaxis in minimal-access surgery.

Beekman R et al. · Canadian journal of surgery. Journal canadien de chirurgie, 2006

DOIPubMed

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