P. Smart MBBS, FRACS; K. Burbury FRACP, FRCPA; S. Lingaratnam BPharm, MPH; A. C. Lynch MMedSci, FRACS; J. Mackay FRACS, FRCS (Eng.); A. Heriot MD, FRACS.
Thromboprophylaxis among Australasian colorectal surgeons
Article first published online: 17 SEP 2012
© 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons
ANZ Journal of Surgery
Volume 83, Issue 9, pages 646–650, September 2013
How to Cite
Smart, P., Burbury, K., Lingaratnam, S., Lynch, A. C., Mackay, J. and Heriot, A. (2013), Thromboprophylaxis among Australasian colorectal surgeons. ANZ Journal of Surgery, 83: 646–650. doi: 10.1111/j.1445-2197.2012.06245.x
- Issue published online: 2 SEP 2013
- Article first published online: 17 SEP 2012
- Manuscript Accepted: 9 JUL 2012
- colorectal neoplasm;
- colorectal surgery;
- health care survey;
Thromboembolism is a common cause of morbidity and mortality in patients with colorectal cancer, but thromboprophylaxis (TP) is underutilized. Current guidelines do not make specific recommendations for colorectal cancer patients and provide minimal guidance for the ambulatory setting, although emerging evidence suggests TP may be warranted during chemoradiotherapy or in the extended post-operative phase. A survey of Australasian colorectal surgeons was therefore performed to assess current TP practice and attitudes.
An online survey was sent to 204 surgeons who were members of the Colorectal Surgical Society of Australia and New Zealand.
One hundred twenty-eight surgeons (63%) completed the survey. Most surgeons consult available guidelines, and where recommendations are made, current practice is in line with them. Lack of data, lack of ownership, logistical issues and an absence of guideline recommendations currently prevent surgeons from instituting TP in the neoadjuvant treatment period. Fifty-four per cent of surgeons currently prescribe TP after hospital discharge; those that do not, cite logistical issues as the main constraint.
More data on thromboembolism risk during various treatment phases are required and should be promulgated in tumour-specific guidelines. Logistical barriers to adopting TP in the ambulatory setting should be addressed.