Masayoshi Yasui1, Masataka Ikeda2,3, Taishi Hata4,5, Shu Okamura6, Yasuhiro Miyake7,8, Hideki Sakisaka9, Hidekazu Takahashi4, Norikatsu Miyoshi4, Mamoru Uemura4, Tsunekazu Mizushima4, Hirofumi Yamamoto4, Kohei Murata6,5, Yuichiro Doki4, Hidetoshi Eguchi4. 1. Department of Gastroenterological Surgery, Osaka International Cancer Institute, Otemae 3-1-69, Chuo-ku, Osaka, Japan. myasui-gi@umin.ac.jp. 2. Department of Surgery, Osaka National Hospital, Osaka, Japan. 3. Department of Gastroenterological Surgery, Division of Lower GI, Hyogo College of Medicine, Nishinomiya, Japan. 4. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan. 5. Department of Surgery, Kansai Rosai Hospital, Amagasaki, Japan. 6. Department of Surgery, Suita Municipal Hospital, Suita, Japan. 7. Department of Surgery, Nishinomiya Municipal Central Hospital, Nishinomiya, Japan. 8. Department of Surgery, Osaka Minato Central Hospital, Osaka, Japan. 9. Department of Surgery, Kawanishi City Hospital, Kawanishi, Japan.
Abstract
PURPOSE: Postoperative venous thromboembolism (VTE) is a major and potentially fatal postoperative complication of colorectal cancer surgery. However, there is uncertainty about the necessity for anticoagulant prophylaxis to prevent VTE after laparoscopic colorectal cancer surgery because of its associated relatively lower incidence. Currently, anticoagulant therapy is considered mainly for patients at high risk of the development of VTE. Focusing on proximal deep vein thrombosis (DVT)/ pulmonary embolism (PE), we aimed to identify those cases at high risk of the development of fatal VTE. METHODS: We performed an exploratory retrospective analysis to identify the risk factors for postoperative proximal DVT and PE after laparoscopic colorectal cancer surgery in patients included in our prospective trial. RESULTS: A logistic regression analysis revealed factors that could predict the onset of proximal DVT/PE in patients with colorectal cancer. Blood loss and tumor location were identified as the predictors of proximal DVT/PE. CONCLUSIONS: Patients with rectal cancer and those with excessive blood loss during colon cancer surgery must be monitored carefully for signs of VTE and especially proximal DVT/PE, after laparoscopic surgery.
PURPOSE: Postoperative venous thromboembolism (VTE) is a major and potentially fatal postoperative complication of colorectal cancer surgery. However, there is uncertainty about the necessity for anticoagulant prophylaxis to prevent VTE after laparoscopic colorectal cancer surgery because of its associated relatively lower incidence. Currently, anticoagulant therapy is considered mainly for patients at high risk of the development of VTE. Focusing on proximal deep vein thrombosis (DVT)/ pulmonary embolism (PE), we aimed to identify those cases at high risk of the development of fatal VTE. METHODS: We performed an exploratory retrospective analysis to identify the risk factors for postoperative proximal DVT and PE after laparoscopic colorectal cancer surgery in patients included in our prospective trial. RESULTS: A logistic regression analysis revealed factors that could predict the onset of proximal DVT/PE in patients with colorectal cancer. Blood loss and tumor location were identified as the predictors of proximal DVT/PE. CONCLUSIONS: Patients with rectal cancer and those with excessive blood loss during colon cancer surgery must be monitored carefully for signs of VTE and especially proximal DVT/PE, after laparoscopic surgery.
Authors: A N Nicolaides; J Fareed; A K Kakkar; A J Comerota; S Z Goldhaber; R Hull; K Myers; M Samama; J Fletcher; E Kalodiki; D Bergqvist; J Bonnar; J A Caprini; C Carter; J Conard; B Eklof; I Elalamy; G Gerotziafas; G Geroulakos; A Giannoukas; I Greer; M Griffin; S Kakkos; M R Lassen; G D Lowe; A Markel; P Prandoni; G Raskob; A C Spyropoulos; A G Turpie; J M Walenga; D Warwick Journal: Int Angiol Date: 2013-04 Impact factor: 2.789