Abstract
Background
The occurrence of venous thromboembolism (VTE), manifesting as deep vein thrombosis or pulmonary embolism, after gastric and colorectal cancer surgery remains poorly characterized. The purpose of this study was to investigate the incidence of VTE following laparoscopic surgery in Japanese patients with gastric and colorectal cancer and identify the associated risk factors.
Methods
We prospectively analyzed VTE events after laparoscopic surgery for gastric and colorectal cancer from April 2012 to March 2013 in our institute. Deep vein thrombosis was diagnosed with Doppler ultrasound sonography of the lower limb. Thromboprophylaxis, graduated compression stockings, and intermittent pneumatic compression were used in all patients. Fondaparinux sodium was used in several patients. We examined all patients’ plasma D-dimer levels throughout the perioperative period.
Results
In total, 101 patients were enrolled in this study; 71 who underwent laparoscopic surgery for gastrointestinal cancer were finally analyzed. Thirteen patients (18.3 %) developed asymptomatic VTE. There were no relationships between the development of VTE and perioperative factors such as cardiovascular disease, operation time, blood loss, postoperative complications, and fondaparinux administration. Neoadjuvant treatment (chemotherapy or chemoradiotherapy) was significantly associated with VTE (p < 0.05). Plasma D-dimer levels were higher 7 days after surgery in patients with than without VTE, although the levels remained high after surgery in all patients.
Conclusions
The incidence of VTE among Japanese patients who underwent laparoscopic surgery for gastrointestinal cancer was not low. In particular, clinicians should consider the higher risk of VTE in patients undergoing neoadjuvant therapy.
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References
Sakon M, Maehara Y, Yoshikawa H et al (2006) Incidence of venous thromboembolism following major abdominal surgery: a multi-center, prospective epidemiological study in Japan. J Thromb Haemost JTH 4:581–586
Borly L, Wille-Jorgensen P, Rasmussen MS (2005) Systematic review of thromboprophylaxis in colorectal surgery—an update. Colorectal Dis 7:122–127
Geerts WH, Bergqvist D, Pineo GF et al (2008) Prevention of venous thromboembolism: American college of chest physicians evidence-based clinical practice guidelines (8th edition). Chest 133:381s–453s
Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Guidelines Committee (2007) Guidelines for deep venous thrombosis prophylaxis during laparoscopic surgery. Surg Endosc 21:1007–1009
Buchberg B, Masoomi H, Lusby K et al (2011) Incidence and risk factors of venous thromboembolism in colorectal surgery: does laparoscopy impart an advantage? Arch Surg (Chicago, Ill: 1960) 146:739–743
Colditz GA, Tuden RL, Oster G (1986) Rates of venous thrombosis after general surgery: combined results of randomised clinical trials. Lancet 2:143–146
Denstman F, Lowry A, Vernava A (2000) Practice parameters for the prevention of venous thromboembolism. The Standards Task Force of the American Society of Colon and Rectal Surgeons. Dis Colon Rectum 43:1037–1047
Jamal MH, Corcelles R, Shimizu H et al (2015) Thromboembolic events in bariatric surgery: a large multi-institutional referral center experience. Surg Endosc 29:376–380
Larsen AC, Dabrowski T, Frokjaer JB et al (2014) Prevalence of venous thromboembolism at diagnosis of upper gastrointestinal cancer. Br J Surg 101:246–253
Cohen AT, Wagner MB, Mohamed MS (1997) Risk factors for bleeding in major abdominal surgery using heparin thromboprophylaxis. Am J Surg 174:1–5
Mismetti P, Laporte S, Darmon JY et al (2001) Meta-analysis of low molecular weight heparin in the prevention of venous thromboembolism in general surgery. Br J Surg 88:913–930
Turpie AG, Bauer KA, Caprini JA et al (2007) Fondaparinux combined with intermittent pneumatic compression vs. intermittent pneumatic compression alone for prevention of venous thromboembolism after abdominal surgery: a randomized, double-blind comparison. J Thromb Haemost JTH 5:1854–1861
Blom JW, Vanderschoot JP, Oostindier MJ et al (2006) Incidence of venous thrombosis in a large cohort of 66,329 cancer patients: results of a record linkage study. J Thromb Haemost JTH 4:529–535
Samama MM (2000) An epidemiologic study of risk factors for deep vein thrombosis in medical outpatients: the Sirius study. Arch Intern Med 160:3415–3420
Byrne M, Reynolds JV, O’Donnell JS et al (2010) Long-term activation of the pro-coagulant response after neoadjuvant chemoradiation and major cancer surgery. Br J Cancer 102:73–79
Haddad TC, Greeno EW (2006) Chemotherapy-induced thrombosis. Thromb Res 118:555–568
Wells PS (2007) Integrated strategies for the diagnosis of venous thromboembolism. J Thromb Haemost JTH 5(Suppl 1):41–50
Bounameaux H, Schneider PA, Reber G et al (1989) Measurement of plasma D-dimer for diagnosis of deep venous thrombosis. Am J Clin Pathol 91:82–85
Wells PS, Owen C, Doucette S et al (2006) Does this patient have deep vein thrombosis? JAMA 295:199–207
Acknowledgment
This study was supported by GlaxoSmithKline.
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Kimura, Y., Oki, E., Ando, K. et al. Incidence of Venous Thromboembolism Following Laparoscopic Surgery for Gastrointestinal Cancer: A Single-Center, Prospective Cohort Study. World J Surg 40, 309–314 (2016). https://doi.org/10.1007/s00268-015-3234-y
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DOI: https://doi.org/10.1007/s00268-015-3234-y