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Risk factors for postoperative proximal deep vein thrombosis and pulmonary embolism after laparoscopic colorectal cancer surgery: analysis of a multicenter randomized controlled trial

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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.

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Acknowledgements

We thank the following for their expert assistance: Masakazu Miyake from the Department of Surgery, National Hospital Organization Osaka National Hospital; Yoshihito Ide from the Department of Surgery, Japan Community Health Care Organization Osaka Hospital; Masakazu Ikenaga from the Department of Gastroenterological surgery, Higashiosaka City Medical Center; Kotaro Kitani from the Department of Gastroenterological Surgery, Kindai University Nara Hospital; Shunji Morita from the Department of Surgery, Itami City Hospital

Funding

None.

Author information

Authors and Affiliations

  1. Department of Gastroenterological Surgery, Osaka International Cancer Institute, Otemae 3-1-69, Chuo-ku, Osaka, Japan

    Masayoshi Yasui

  2. Department of Surgery, Osaka National Hospital, Osaka, Japan

    Masataka Ikeda

  3. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan

    Taishi Hata, Hidekazu Takahashi, Norikatsu Miyoshi, Mamoru Uemura, Tsunekazu Mizushima, Hirofumi Yamamoto, Yuichiro Doki & Hidetoshi Eguchi

  4. Department of Surgery, Suita Municipal Hospital, Suita, Japan

    Shu Okamura & Kohei Murata

  5. Department of Surgery, Nishinomiya Municipal Central Hospital, Nishinomiya, Japan

    Yasuhiro Miyake

  6. Department of Surgery, Kawanishi City Hospital, Kawanishi, Japan

    Hideki Sakisaka

  7. Department of Surgery, Kansai Rosai Hospital, Amagasaki, Japan

    Taishi Hata & Kohei Murata

  8. Department of Surgery, Osaka Minato Central Hospital, Osaka, Japan

    Yasuhiro Miyake

  9. Department of Gastroenterological Surgery, Division of Lower GI, Hyogo College of Medicine, Nishinomiya, Japan

    Masataka Ikeda

Authors
  1. Masayoshi Yasui
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  2. Masataka Ikeda
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  3. Taishi Hata
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  4. Shu Okamura
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  5. Yasuhiro Miyake
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  6. Hideki Sakisaka
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  7. Hidekazu Takahashi
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  8. Norikatsu Miyoshi
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  9. Mamoru Uemura
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  10. Tsunekazu Mizushima
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  11. Hirofumi Yamamoto
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  12. Kohei Murata
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  13. Yuichiro Doki
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  14. Hidetoshi Eguchi
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Consortia

the Clinical Study Group of Osaka University (CSGO), Colorectal Group

Contributions

All authors made substantial contributions to the study conception and design. MY, MI, TH, SO, YM, HS, KM: acquisition and interpretation of data. MY: data analysis and interpretation of data. All authors participated in drafting the manuscript and revising it critically for important content. All authors gave final approval of the version to be published. All authors agreed to be accountable for every aspect of the work to ensure that questions related to the accuracy or integrity of any part of the work are investigated and resolved appropriately.

Corresponding author

Correspondence to Masayoshi Yasui.

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Conflict of interest

We have no relevant financial or non-financial interests to disclose.

Ethics approval statement

All procedures in studies involving human participants were carried out in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Patient consent statement

Participation and publication consent of patients included in this study was obtained through a written consent document.

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Cite this article

Yasui, M., Ikeda, M., Hata, T. et al. Risk factors for postoperative proximal deep vein thrombosis and pulmonary embolism after laparoscopic colorectal cancer surgery: analysis of a multicenter randomized controlled trial. Surg Today 52, 881–888 (2022). https://doi.org/10.1007/s00595-021-02422-2

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  • DOI: https://doi.org/10.1007/s00595-021-02422-2

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