Routine surveillance for diagnosis of venous thromboembolism after pleurectomy for malignant pleural mesothelioma.
Routine surveillance for diagnosis of venous thromboembolism after pleurectomy for malignant pleural mesothelioma.
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恶性胸膜间皮瘤胸膜切除术后静脉血栓栓塞诊断的常规监测。
DOI：
10.1016/j.jtcvs.2019.12.115
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Bueno,Raphael
中科院分区：
文献类型：
--
作者：
DeLeón,LuisE;Bravo-Iñiguez,CarlosE;Fox,Sam;Tarascio,Jeffrey;Freyaldenhoven,Samuel;Lapidot,Moshe;Jaklitsch,MichaelT;Bueno,Raphael
目的探讨间皮瘤手术患者静脉血栓形成的发生率及常规监测方法的有效性。在这一组中寻找静脉血栓栓塞症的标准化监测计划包括术后每隔7天或更早(如果有症状)进行一次无创检查。所有患者在预防性肝素治疗的基础上加用外用气动加压套。如果发现深静脉血栓或肺血栓，则开始肝素滴注，直至转为治疗性抗凝。7名患者被发现有术前深静脉血栓形成，因此只有93名患者被纳入分析。手术患者的中位年龄为71岁(30-85岁)。在研究期间，30名患者(32%)出现血栓形成的证据；20名患者(22%)仅出现深静脉血栓而不发生栓塞，3名患者(3%)仅出现肺血栓，7名患者(7%)同时出现深静脉血栓和肺血栓。在发生深静脉血栓形成的27名患者中，9名(33%)在诊断时没有症状，这些患者中没有一人出现肺血栓或其他出血并发症。发生2例(2%)与治疗性抗凝有关的术后大出血。结论间皮瘤术后监测中静脉血栓栓塞症的发生率较高(32%)。高达33%的深静脉血栓患者在确诊时没有症状，与抗凝相关的并发症发生率很低。常规监测可能有助于在深静脉血栓发展为症状性或致命性肺血栓之前诊断和治疗。
ObjectiveThe purpose of this study was to determine the incidence of venous thromboembolism and utility of a routine surveillance program in patients undergoing surgery for mesothelioma.MethodsPatients undergoing pleurectomy from May 2016 to August 2018 were included. A standardized surveillance program to look for venous thromboembolism in this group included noninvasive studies every 7 days postoperatively or earlier if symptomatic. All patients received external pneumatic compression sleeves in addition to prophylactic heparin. If deep vein thrombosis or pulmonary embolus was discovered, heparin drip was initiated until conversion to therapeutic anticoagulation.ResultsA total of 100 patients underwent pleurectomy for mesothelioma. Seven patients were found to have preoperative deep vein thrombosis, and as such only 93 patients were included for analysis. The median age of patients at surgery was 71 years (30-85 years). During the study, 30 patients (32%) developed evidence of thrombosis; 20 patients (22%) developed only deep vein thrombosis without embolism, 3 patients (3%) developed only pulmonary embolism, and 7 patients (7%) developed both deep vein thrombosis and pulmonary embolus. Of the 27 patients who developed deep vein thrombosis, 9 (33%) were asymptomatic at the time of diagnosis, and none of these developed a pulmonary embolus or other bleeding complications. There were 2 (2%) events of major postoperative bleeding related to therapeutic anticoagulation.ConclusionsThe incidence of venous thromboembolism is high (32%) among patients undergoing surveillance after pleurectomy for mesothelioma. Up to 33% of patients with deep vein thrombosis are asymptomatic at the time of diagnosis, and the incidence of complications related to anticoagulation is low. Routine surveillance may be useful to diagnose and treat deep vein thrombosis before it progresses to symptomatic or fatal pulmonary embolus.
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恶性胸膜间皮瘤的血栓栓塞事件
DOI：
--
发表时间：
2016
期刊：
Clinical and applied thrombosis/hemostasis
影响因子：
--
作者：
D. Koksal;O. Safak;A. Ozcan;Y. Ağaçkıran;H. Erturk;G. Fındık
通讯作者：
G. Fındık
影响因子：
3.4
作者：
Borasio, Piero;Berruti, Alfredo;Ardissone, Francesco
通讯作者：
Ardissone, Francesco
影响因子：
--
作者：
Kostron, Arthur;Friess, Martina;Opitz, Isabelle
通讯作者：
Opitz, Isabelle
影响因子：
0.7
作者：
Kodadek, Lisa M.;Haut, Elliott R.
通讯作者：
Haut, Elliott R.
影响因子：
3.1
作者：
Kotaska A
通讯作者：
Kotaska A