In this issue of JAMA Surgery, Jung and colleagues1 examine the safety and efficacy of venous thromboembolism (VTE) prophylaxis in Korean patients undergoing gastrectomy for cancer. Their randomized clinical trial found decreased postoperative VTE with the use of low-molecular-weight heparin in addition to mechanical prophylaxis, compared with the use of mechanical prophylaxis alone. However, the authors claim that, because the VTE rate was low and the rate of bleeding was increased, VTE prophylaxis (low-molecular-weight heparin plus intermittent pneumatic compression) still may not be the right choice for all patients undergoing gastrectomy. Although we were pleased to see this focus on VTE, which until recently was understudied in Asian patients,2 we do have some questions about this trial and its conclusions.
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Owodunni OP, Weiss MJ, Haut ER. Is Venous Thromboembolism in Asian Patients Undergoing Gastrectomy Different From Venous Thromboembolism in Their Western Counterparts?. JAMA Surg. Published online July 18, 2018. doi:10.1001/jamasurg.2018.2082
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