Extended thromboprophylaxis significantly reduces venous thromboembolism (VTE) risk after colorectal surgery without increasing bleeding complications.

• VTE rates were reduced to 0.56% with low molecular weight heparin (LMWH) and 0.22% with direct oral anticoagulants (DOAC), compared to no extended treatment.
• No major bleeding events differed between LMWH and DOAC groups at 90 days.

For high-risk patients, implementing extended thromboprophylaxis for at least 28 days can enhance postoperative outcomes.