Prevention of Venous Thromboembolic Disease in Colorectal Surgery

Publication Date: January 1, 2018
Last Updated: March 14, 2022


The use of a VTE risk assessment model is recommended to guide VTE prophylaxis in patients undergoing colorectal surgery. (2A)

Mechanical strategies for VTE prophylaxis, including early mobilization and intermittent pneumatic compression (IPC) devices, should be deployed for patients undergoing colorectal surgery. (1B)

Pharmacological thromboprophylaxis with either LMWH or LDUH should typically be given to patients undergoing colorectal operations who are deemed to be at moderate or high risk for VTE, who are not identified as high risk for bleeding complications. (1A)

For high VTE risk patients undergoing colorectal surgery, where chemoprophylaxis is contraindicated or previously found to be insufficient, an inferior vena cava (IVC) filter may be considered. (2C)

In patients undergoing colorectal cancer resection deemed to be at high risk for VTE, strong consideration should be given to extended-duration pharmacological thromboprophylaxis (4 weeks). (1B)

Patients with IBD are at high risk for DVT and select patients may benefit from extended prophylaxis. (2C)

Recommendation Grading




Prevention of Venous Thromboembolic Disease in Colorectal Surgery

Authoring Organization

Publication Month/Year

January 1, 2018

Last Updated Month/Year

June 7, 2023

Supplemental Implementation Tools

Document Type


External Publication Status


Country of Publication


Inclusion Criteria

Male, Female, Adult, Older adult

Health Care Settings

Ambulatory, Emergency care, Outpatient, Operating and recovery room

Intended Users

Nurse, nurse practitioner, physician, physician assistant


Assessment and screening, Management, Prevention

Diseases/Conditions (MeSH)

D054556 - Venous Thromboembolism, D020246 - Venous Thrombosis, D003107 - Colorectal Surgery


pulmonary embolism, Venous Thromboembolic, Colorectal Surgery, deep venous thrombosis

Source Citation

Fleming, Fergal M.D.; Gaertner, Wolfgang M.D.; Ternent, Charles A. M.D.; Finlayson, Emily M.D., M.S.; Herzig, Daniel M.D.; Paquette, Ian M. M.D.; Feingold, Daniel L. M.D.; Steele, Scott R. M.D. The American Society of Colon and Rectal Surgeons Clinical Practice Guideline for the Prevention of Venous Thromboembolic Disease in Colorectal Surgery, Diseases of the Colon & Rectum: January 2018 - Volume 61 - Issue 1 - p 14-20 doi: 10.1097/DCR.0000000000000982

Supplemental Methodology Resources

Data Supplement


Number of Source Documents
Literature Search Start Date
January 1, 2003
Literature Search End Date
December 1, 2016