Comparison of enoxaparin and standard heparin in gynaecologic oncologic surgery: A randomised prospective double-blind clinical study

Objective: This study aimed to compare the haemorrhagic complications and e fficacy of enoxaparin, a low molecular weight heparin (LMWH), and conventio nal standard heparin (SH) in gynaecological oncologic surgery. Materials Methods: A double blind, randomised trial was performed on 102 co nsecutive women undergoing gynaecologic cancer surgery with pelvic and para aortic lymphadenectomy. The women were separated into those who were given 2,500 IU enoxaparin once daily and SH in a dose of 5,000 IU three times dai ly. The groups were analysed for intraoperative blood loss, drainage, trans fusion requirements. perioperative haemoglobin decrease, wound haematoma, a nd clinical deep venous thrombosis. Results: The two groups were well matched for age, weight, and other factor s, which could predispose to the development of deep venous thrombosis (DVT ) and haemorrhage. No patient developed clinical significant DVT. wound hae matoma or intra-abdominal bleeding. There was no significant difference in bleeding complications between the two regimens. The antiFXa level in the p lasma was correlated strongly with patient weight. Conclusions: A dose of 2,500 IU enoxaparin/day does not cause more bleeding complications than SH 5,000 IU three times daily when used to prevent thro mbosis. However. the dose of enoxaparin must be adjusted to the patient's w eight.