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Background: Due to lack of data, direct oral anticoagulants are not considered by guidelines for venous thromboembolism (VTE) prophylaxis after cancer surgery.Adherence to low-molecular-weight heparin injections in this setting is sometimes poor.Aim: Analysis of adherence to oral apixaban for extended thromboprophylaxis.Methods: Consecutive patients discharged after major surgery for abdominal/pelvic cancer and considered eligible for extended prophylaxis were offered apixaban 2.5 mg twice daily. Primary outcomes were adherence metrics-proportion of prescriptions filled, persistence (not prematurely discontinued), proportion of days covered (PDC) based on apixaban pill counts, and modified Morisky medication adherence scale at Days 28-30. Secondary outcomes were bleeding, VTE, and serious adverse events until Day 90.Results: We included 53 patients, 51 were analyzed. Of 45 patients with prescriptions all had it filled (95% confidence interval [CI], 92%-100%). Persistence was 98% (95% CI, 90%-100%). PDC was ≥80% for 48 patients (94%; 95% CI, 84%-99%). We found good adherence (0/6 answers "yes") in 75% and moderate (1/ 6 answers "yes") in 25%. No major bleed or VTE occurred while on apixaban. Conclusion:Our results support good adherence with apixaban for VTE prophylaxis up to 28 days after major abdominal or pelvic cancer surgery.

Highlights: Aggressive angiomyxoma tends toward two forms: deeply invasive and pedunculated. Anti-hormonal therapy can be an adjunct to aggressive angiomyxoma treatment. Pedunculated aggressive angiomyxoma can be considered for shorter follow-up.

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group(n=115) which received(0.5% bupivacaine Hcl) as a single dose by subcutaneous infiltration at the site of incision before the skin closure, where the patients were still anaesthetized. Control group was treated with standard of care post operative systemic pain medication. The degree of pain was assessed by using visual analogue pain scores (1-10).On early postoperative day opioid consumption was also significantly reduced. Other elements of postoperative phase of ERAS program is also improved .Chi-square(x2)test, Fischer's exact test, student t test were used in data analysis. ResultsThe group treated with per operative wound infiltration with bupivacaine Hcl has lower pain score(<0.001), lower the consumption of opioid (<0.05),earlier mobilization (p <0.001),fewer consumption to bed ( p<0.001),better patient satisfaction(p<0.05) but no significant difference in complication rate. Conclusions Wound infiltration with bupivacaine Hcl into surgical site effectively reduced pain and opioid consumption and PONV .Bupivacaine Hcl is safe ,well tolerated and superior to traditional systemic pain medication in both self reported and clinical out come among the patient who underwent extensive pelvic gynae concogical surgery and enhance ERAS program EP372/#1117 TOTALLY IMPLANTABLE CENTRAL VENOUS CATHETER IN ONCOLOGIC PATIENTS: A SINGLE-CENTER EXPERIENCE