Clinical Investigation of Hepatic Function Impairment Induced by Low Molecular Weight Heparin During Perioperative Period of Esophageal Cancer Surgery

Abstract

Background: Esophageal carcinoma poses a significant global health challenge, marked by high incidence rates and poor prognosis. This study aimed to assess the impact of low molecular weight heparins (LMWH) on liver function during the perioperative period of esophageal cancer surgery, particularly given the hepatotoxic potential of LMWH that remains underexplored. Objectives: The present study aimed to evaluate the effects of LMWH on liver function in patients undergoing esophageal cancer surgery. Methods: A retrospective analysis was conducted on 31 patients who underwent complete endoscopic radical removal of esophageal cancer between February 2023 and June 2024, with a mean age of 57.32 years. Participants were divided into an LMWH group (n = 21) and a control group (n = 10). Clinical data were compared, and liver function markers — direct bilirubin, indirect bilirubin, cholinesterase, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) — were measured preoperatively and on postoperative days 1, 3, 5, 7, and 11. Informed consent was obtained from all participants. Results: No significant differences in demographic and clinical parameters were found between the LMWH and control groups (P > 0.05). Both groups showed similar trends in bilirubin levels, with significant postoperative changes (P < 0.05). Cholinesterase levels decreased initially but increased by day seven post-surgery. Differences in ALT and AST levels were noted on specific postoperative days, indicating varied liver function responses to treatment (P < 0.05). Conclusions: Patients undergoing esophageal cancer surgery who receive LMWH may experience liver dysfunction. Continuous monitoring of liver enzyme levels is recommended, and alternative anticoagulation strategies should be considered if impairment is observed.