Reduction of Venous Thromboembolic Disease in Colorectal Surgery

Publication Date: June 12, 2023
Last Updated: October 13, 2023

Summary of Recommendations

VTE risk scores may be used when individuals are undergoing colorectal surgery to allow for an informed discussion regarding the risks and benefits of VTE prophylaxis. (S, L)

A clinical decision support system embedded into existing electronic health systems may be considered to improve compliance with inpatient VTE prophylaxis recommendations. (S, L)

Mechanical strategies may be used in patients undergoing colorectal surgery, especially in those with a contraindication to chemical prophylaxis. (S, M)

Early postoperative mobilization and/or physical therapy may be incorporated into recovery pathways after colorectal resection. (C, VL)

Inpatient pharmacologic thromboprophylaxis should be given to patients undergoing colorectal surgery who are considered moderate to high risk for VTE and are not at high risk for bleeding complications. (S, H)

In patients with an increased risk of VTE and a contraindication to chemoprophylaxis, routine use of inferior vena cava filters is not recommended. (C, VL)

Routine mechanical or chemical VTE prophylaxis is not recommended in patients undergoing ambulatory colorectal surgery. (C, VL)

In patients undergoing a colorectal cancer resection deemed to be at high risk of VTE, extended-duration pharmacological thromboprophylaxis may be considered. (C, H)

In patients undergoing colorectal resection for IBD deemed to be at high risk of VTE, extended-duration pharmacological thromboprophylaxis may be considered. (C, VL)

When extended VTE prophylaxis is recommended, the duration of prophylaxis remains unknown. (C, VL)

Recommendation Grading


  • CD: Crohn's Disease
  • DVT: Deep Vein Thrombosis
  • IBD: Inflammatory Bowel Disease
  • PE: Pulmonary Embolism
  • UC: Ulcerative Colitis
  • VTE: Venous Thromboembolism


The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.



Reduction of Venous Thromboembolic Disease in Colorectal Surgery

Authoring Organization

Publication Month/Year

June 12, 2023

Last Updated Month/Year

November 6, 2023

Supplemental Implementation Tools

Document Type


Country of Publication


Document Objectives

These clinical practice guidelines aim to present and grade the evidence for risk stratification and prevention of VTE for those undergoing colorectal surgery. It is important for the reader to distinguish that some of the studies report clinically symptomatic VTE, whereas others report asymptomatic screened VTE, and this distinction needs to be taken into account when interpreting this literature.

Target Patient Population

Patients undergoing colorectal surgery

Target Provider Population

Colon and rectal surgeons, gastroenterologists and other clinicians caring for patients undergoing colorectal surgery

Inclusion Criteria

Male, Female, Adolescent, Adult, Child, Infant, Older adult

Health Care Settings

Ambulatory, Outpatient, Operating and recovery room

Intended Users

Nurse, nurse practitioner, physician, physician assistant


Assessment and screening, Prevention

Diseases/Conditions (MeSH)

D054556 - Venous Thromboembolism, D003107 - Colorectal Surgery


VTE, VTE Prophylaxis, Colorectal Surgery

Source Citation

Patel, Sunil V. M.D.1; Liberman, Sender A. M.D.2; Burgess, Pamela L. M.D.3; Goldberg, Joel E. M.D.4; Poylin, Vitaliy Y. M.D.5; Messick, Craig A. M.D.6; Davis, Bradley R. M.D.7; Feingold, Daniel L. M.D.8; Lightner, Amy L. M.D.9; Paquette, Ian M. M.D.10. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Reduction of Venous Thromboembolic Disease in Colorectal Surgery. Diseases of the Colon & Rectum 66(9):p 1162-1173, September 2023. | DOI: 10.1097/DCR.0000000000002975 

Supplemental Methodology Resources

Data Supplement


Number of Source Documents
Literature Search Start Date
July 1, 2021
Literature Search End Date
December 19, 2022