Is there a place for primary prevention in one-day surgery and fast-track surgery?
DOI:
https://doi.org/10.11603/2414-4533.2026.3.16625Keywords:
ambulatory surgery, one-day surgery, fast-track surgery, venous thromboembolism, primary thromboprophylaxis, risk stratification, low-weight molecular heparinsAbstract
The aim of the work: to summarize and critically analyze current evidence on the primary prevention of venous thromboembolic complications in patients undergoing procedures in one-day surgery and fast-track surgery settings, with particular emphasis on risk stratification, the choice of prophylactic method, the timing of initiation, and the duration of thromboprophylaxis.
Materials and Methods. A structured review of publications from 2012 to 2024 was conducted using PubMed/MEDLINE, Scopus, Web of Science, the Cochrane Library, and the official resources of professional societies. Clinical guidelines, systematic reviews, randomized trials, and observational studies evaluating the incidence of venous thromboembolism, risk factors, the effectiveness of mechanical and pharmacological prophylaxis, and the risk of bleeding were analyzed.
Results. The overall incidence of symptomatic venous thromboembolism after outpatient surgical procedures is low; however, it increases in older patients and in those with cancer, obesity, thrombophilia, a history of thrombosis, prolonged surgery, or limited mobility. In low-risk patients, early mobilization, adequate hydration, and, when indicated, mechanical prophylaxis may be sufficient. In the presence of additional risk factors, the use of low-molecular-weight heparins is appropriate, whereas evidence supporting direct oral anticoagulants in general outpatient surgical practice remains insufficient.
Conclusions. Primary thromboprophylaxis has an important role in one-day and fast-track surgery but should be individualized. Routine administration of anticoagulants to all patients is not justified; preference should be given to risk stratification, early mobilization, and the selective use of low-molecular-weight heparins.
References
1. Samama CM, Afshari A, Grønlykke L, Madsen MH, Wiberg S, Romero CS. European guidelines on peri-operative venous thromboembolism prophylaxis: first update. Executive summary. Eur J Anaesthesiol. 2024; 41(8):561-69. DOI: 10.1097/EJA.0000000 000002025. DOI: https://doi.org/10.1097/EJA.0000000000002025
2. Jørgensen CC, Llau J, Jenny JY, Albaladejo P. European guidelines on peri-operative venous thromboembolism prophylaxis: first update. Chapter 3: Day surgery and fast-track surgery. Eur J Anaesthesiol. 2024; 41(8):577-81. DOI: 10.1097/EJA.000000 0000002010.
3. Stanak M, Strohmaier C. Minimum volume standards in day surgery: a systematic review. BMC Health Serv Res. 2020; 20:886. DOI: 10.1186/s12913-020-05724-2. DOI: https://doi.org/10.1186/s12913-020-05724-2
4. Wainwright TW, Gill M, McDonald DA, Middleton RG, Reed M, Sahota O, et al. Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Acta Orthop. 2020; 91(1):3-19. DOI: 10.1080/17453674.2019.1683790. DOI: https://doi.org/10.1080/17453674.2019.1683790
5. Albaladejo P, Llau J, Jenny JY, Jørgensen CC. European guidelines on perioperative venous thromboembolism prophylaxis: first update. Chapter 3: Day surgery and fast-track surgery. Eur J Anaesthesiol. 2024; 41(8):577-81. DOI: 10.1097/EJA.000000 0000002010. DOI: https://doi.org/10.1097/EJA.0000000000002010
6. Morán LO, Mateo FJP, Balanyà RP, Revuelta JR, Martínez SR, Fombella JPB, et al. SEOM clinical guidelines on venous thromboembolism (VTE) and cancer (2023). Clin Transl Oncol. 2024; 26(11):2877-901. DOI: 10.1007/s12094-024-03605-2. DOI: https://doi.org/10.1007/s12094-024-03605-2
7. Panucci CJ, Shanks A, Moote MJ, et al. Identifying patients at high risk for venous thromboembolism requiring treatment after outpatient surgery. Ann Surg. 2012; 255(6):1093-99. DOI: 10.1 097/SLA.0b013e3182519ccf. DOI: https://doi.org/10.1097/SLA.0b013e3182519ccf
8. Haas S, Hohmann V, Bramlage P. Prevention of venous thromboembolism using enoxaparin in day surgery: results of the SMART non-interventional study. Clin Appl Thromb Hemost. 2012; 18(3):265-71. DOI: 10.1177/1076029611425379. DOI: https://doi.org/10.1177/1076029611425379
9. National Institute for Health and Care Excellence. Venous thromboembolism: reducing the risks of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to hospital [Internet]. London: National Institute for Health and Care Excellence; 2015 [cited 2017 Aug 9]. Available from: [www.nice.org.uk/guidance/cg92](http://www.nice.org.uk/guidance/cg92).
10. Gould MK, García DA, Wren SM, et al. Prevention of VTE in nonorthopedic surgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed. American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012; 141(2 Suppl):e227S–e277S. DOI: 10.1378/chest. 11-2297. DOI: https://doi.org/10.1378/chest.11-2297
11. Bouchard-Fortier G, Geerts WH, Covens A, et al. Is venous thromboprophylaxis necessary in minimally invasive surgery for a gynecologic malignancy? Gynecol Oncol. 2014; 134(2):228-32. DOI: 10.1016/j.ygyno.2014.05.012. DOI: https://doi.org/10.1016/j.ygyno.2014.05.012
12. Stevens SM, Woller SC, Kreuziger LB, Bounameaux H, Doerschug K, Geersing GJ, et al. Antithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel report. Chest. 2021; 160(6):e545–e608. DOI: 10.1016/j.chest. 2021.07.055.
13. Nemeth B, Nelissen R, Arya R, Cannegieter SC. Preventing VTE following total hip and knee arthroplasty: is prediction the future? J. Thromb Haemost. 2021; 19(1):41-5. DOI: 10.1111/jth. 15132. DOI: https://doi.org/10.1111/jth.15132
14. Petersen PB, Kehlet H, Jørgensen CC, Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group. Safety of in-hospital only thromboprophylaxis after fast-track total hip and knee arthroplasty: a prospective follow-up study in 17,582 procedures. Thromb Haemost. 2018; 118(12): 2152-61. DOI: 10.1055/s-0038-1675641. DOI: https://doi.org/10.1055/s-0038-1675641
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Лариса Чернуха, Святослав Костів
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish their work in Hospital Surgery. Journal by L. Ya. Kovalchuk agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
