الفهرس 
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Abstract
VTE is a common complication in cancer surgical patients. The
presence of malignant disease doubles the risk for D.V.T, Clinical
trials have shown that thromboprophylaxis reduces the incidence of
symptomatic venous thrombosis in cancer patients aiming for
prevention, early diagnosis and treatment of deep venous thrombosis.
The aim of this study is to focus on the recent trends in the
management (diagnosis and treatment) of deep vein thrombosis
(DVT) in malignancy.
This prospective study was carried out on 60 patients at Ahmed
Maher teaching hospital and Elmenofeya university hospital in the
period between august 2017 and august 2018. These patients were
divided into two groups, the first group was composed of 30 cancer
patients on whom prophylactic measures against VTE was applied for
eight months, the second group was composed of 30 cancer patients
which already had DVT and underwent management and follow up
for 3-6 months.
All of them were subjected to detailed history taking including
age, obesity, prolonged bed rest, smoking, previous documented DVT,
present illness and history of chemotherapy, Stressing on history of
recent leg swelling and/or aching pain. Also Physical Examination
where The lower limb is inspected for any swelling, collateral
superficial veins, color changes either whitish or bluish and signs of
superficial thrombophlebitis and Patients were also examined for signs
of pulmonary embolism (chest pain, cyanosis, tachycardia, and
tachypnea). Patients also were subjected to routine investigations and
further duplex study of the venous system of suspected limb was performed to confirm the diagnosis and define the extent and level of
DVT.
The first group received drugs as low molecular weight heparin
(LMWH) as prophylaxis starting 12 hours before the operation and for
8 Months (enoxaparin 1 mg/kg twice daily or 1.5 mg/kg once daily).
Also, Mechanical thromoprophylactic measures are applied
such as elastic stocking, leg elevation and early ambulation.
The second group were treated either (with LMWH for at least
6 months and treatment could be extended up to one year in patients
with high risk factors for recurrence or patients who show recurrence
despite anticoagulation) or (with initial anticoagulant with LMWH for
10 days, with early initiation of a vitamin K antagonist (VKA) such as
warfarin for 6 moths up to one year.