الفهرس | Only 14 pages are availabe for public view |
Abstract VTE is a common complication in cancer surgical patients. The presence of malignant disease doubles the risk for D.V.T, Clinical trials have shown that thromboprophylaxis reduces the incidence of symptomatic venous thrombosis in cancer patients aiming for prevention, early diagnosis and treatment of deep venous thrombosis. The aim of this study is to focus on the recent trends in the management (diagnosis and treatment) of deep vein thrombosis (DVT) in malignancy. This prospective study was carried out on 60 patients at Ahmed Maher teaching hospital and Elmenofeya university hospital in the period between august 2017 and august 2018. These patients were divided into two groups, the first group was composed of 30 cancer patients on whom prophylactic measures against VTE was applied for eight months, the second group was composed of 30 cancer patients which already had DVT and underwent management and follow up for 3-6 months. All of them were subjected to detailed history taking including age, obesity, prolonged bed rest, smoking, previous documented DVT, present illness and history of chemotherapy, Stressing on history of recent leg swelling and/or aching pain. Also Physical Examination where The lower limb is inspected for any swelling, collateral superficial veins, color changes either whitish or bluish and signs of superficial thrombophlebitis and Patients were also examined for signs of pulmonary embolism (chest pain, cyanosis, tachycardia, and tachypnea). Patients also were subjected to routine investigations and further duplex study of the venous system of suspected limb was performed to confirm the diagnosis and define the extent and level of DVT. The first group received drugs as low molecular weight heparin (LMWH) as prophylaxis starting 12 hours before the operation and for 8 Months (enoxaparin 1 mg/kg twice daily or 1.5 mg/kg once daily). Also, Mechanical thromoprophylactic measures are applied such as elastic stocking, leg elevation and early ambulation. The second group were treated either (with LMWH for at least 6 months and treatment could be extended up to one year in patients with high risk factors for recurrence or patients who show recurrence despite anticoagulation) or (with initial anticoagulant with LMWH for 10 days, with early initiation of a vitamin K antagonist (VKA) such as warfarin for 6 moths up to one year. |