Incidence of Venous Thromboembolism Following Laparoscopic Surgery for Gastrointestinal Cancer: A Single-Center, Prospective Cohort Study

Yasue Kimura, Eiji Oki, Koji Ando, Hiroshi Saeki, Tetsuya Kusumoto, Yoshihiko Maehara

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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.

Original languageEnglish
Pages (from-to)309-314
Number of pages6
JournalWorld journal of surgery
Volume40
Issue number2
DOIs
Publication statusPublished - Feb 1 2016

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Gastrointestinal Neoplasms
Venous Thromboembolism
Laparoscopy
Cohort Studies
Prospective Studies
Incidence
Intermittent Pneumatic Compression Devices
Stomach Neoplasms
Colorectal Neoplasms
Doppler Ultrasonography
Neoadjuvant Therapy
Venous Thrombosis
Colorectal Surgery
Perioperative Period
Chemoradiotherapy
Ambulatory Surgical Procedures
Pulmonary Embolism
Lower Extremity
Cardiovascular Diseases
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Surgery

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Incidence of Venous Thromboembolism Following Laparoscopic Surgery for Gastrointestinal Cancer : A Single-Center, Prospective Cohort Study. / Kimura, Yasue; Oki, Eiji; Ando, Koji; Saeki, Hiroshi; Kusumoto, Tetsuya; Maehara, Yoshihiko.

In: World journal of surgery, Vol. 40, No. 2, 01.02.2016, p. 309-314.

Research output: Contribution to journalArticle

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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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