Clinical analysis of postoperative venous thromboembolism in Japanese patients after colorectal cancer surgery
Clinical analysis of postoperative venous thromboembolism in Japanese patients after colorectal cancer surgery
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DOI：
10.1007/s00595-020-02201-5
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发表时间：
2021-01-02
期刊：
影响因子：
2.5
通讯作者：
Shimada, Mitsuo
中科院分区：
文献类型：
--
作者：
Yamashita, Shoko;Nishi, Masaaki;Shimada, Mitsuo
目的静脉血栓栓塞（VTE）是腹部手术后的主要并发症，然而，预防术后静脉血栓栓塞的最佳策略尚未建立。我们进行这项研究是为了调查围手术期静脉血栓栓塞的发生率，并评估静脉血栓栓塞预防策略对结直肠癌（CRC）手术患者的有效性。方法回顾性分析2012年至2016年期间接受根治性手术切除的228例结直肠癌患者。患者接受血栓预防治疗，包括依诺肝素。我们评估了围手术期静脉血栓栓塞的发生率，并调查了术后静脉血栓栓塞的危险因素。结果228例患者中，77例术前D-二聚体> 1.0 μ g/mL，12例术前超声诊断为深静脉血栓形成（DVT）。在其余216例患者中，2例患者（0.9%）发生短期VTE（< 30天），7例患者（3.2%）发生长期VTE（30天-3年）。VTE患者的死亡率为0%。单因素分析显示肺部疾病是短期VTE的危险因素，而肥胖、高脂血症和术前肺栓塞史是长期VTE的危险因素（p < 0.05）。结论本分析的结果表明，我们的预防方案，包括依诺肝素是一种有效的策略，以防止术后静脉血栓栓塞。
Purpose Venous thromboembolism (VTE) is a major complication after abdominal surgery; however, the best strategy for preventing VTE after surgery is not yet established. We performed this study to investigate the incidence of perioperative VTE and evaluate the efficacy of a VTE preventive strategy for patients undergoing surgery for colorectal cancer (CRC). Methods The subjects of this retrospective analysis were 228 patients who underwent curative surgical resection for CRC between 2012 and 2016. The patients were treated with thromboprophylaxis including enoxaparin. We assessed the perioperative VTE occurrence rate and investigated the risk factors for postoperative VTE. Results Among the 228 patients, 77 had a preoperative D-dimer level of > 1.0 mu g/mL and 12 had deep vein thrombosis (DVT) diagnosed by ultrasonography preoperatively. Of the remaining 216 patients, short-term VTE (< 30 days) developed in two patients (0.9%) and long-term VTE (30 days-3 years) developed in seven (3.2%). The mortality rate of patients with VTE was 0%. The univariate analysis indicated that pulmonary disease was the risk factor for short-term VTE, whereas obesity, hyperlipidemia, and a preoperative history of pulmonary embolism were the risk factors for long-term VTE (p < 0.05). Conclusion The findings of this analysis show that our preventive protocol including enoxaparin is an effective strategy for preventing postoperative VTE.