Clarke-Pearson DL, Synan IS, Dodge R, Soper JT, Berchuck A, Coleman RE.
A randomized trial of low-dose heparin and intermittent pneumatic calf
compression for the prevention of deep venous thrombosis after gynecologic
oncology surgery.
Am J Obstet Gynecol 1993 Apr;168(4):1146-53; discussion 1153-4

Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710.

OBJECTIVE: Our aim was to determine the relative efficacy and complications of
low-dose heparin and intermittent pneumatic calf compression for the prevention
of postoperative venous thrombosis in patients undergoing surgery for gynecologic
malignancy. STUDY DESIGN: Randomized trial comparing 107 patients treated with
low-dose heparin to 101 patients treated with intermittent pneumatic calf
compression was performed. All patients were evaluated with iodine-125 fibrinogen
scanning of the legs. Clinical and laboratory variables associated with bleeding
complications were recorded prospectively. RESULTS: Venous thrombosis was
diagnosed in seven patients receiving low-dose heparin and in four receiving
intermittent pneumatic calf compression (p = 0.54). Low-dose heparin patients
received more blood transfusions postoperatively (p = 0.02), had increased volume
of retroperitoneal drainage (p = 0.02), and the activated partial thromboplastin
time was more frequently prolonged (p = 0.001). CONCLUSIONS: Low-dose heparin and
intermittent pneumatic calf compression provide similar reduction in reducing the
incidence of postoperative venous thrombosis. However, low-dose heparin is more
frequently associated with postoperative bleeding complications.