Department of Surgery, Faculty of Medicine, Vajira Hospital, University of Bangkok Metropolitan, 681 Samsain Rd., Dusit, Bangkok, 10300, Thailand,
World J Surg. 2014 Jan;38(1):194-202. doi: 10.1007/s00268-013-2222-3.
The general gynecologic and neurologic surgeries are regard as carrying moderate risk for postoperative venous thromboembolism (VTE). This review analyzed the postoperative VTE rate of these surgeries in Asia.
Inclusion criteria were: prospective study; deep vein thrombosis (DVT) diagnosed by venography, ultrasonography, or radionucleotide scan; and no thromboprophylaxis. The pooled proportion was back calculated from Freeman-Tukey variant transformation, using a random effect model.
Medline, EMBASE, Cochrane Library, and KoreaMed were searched. Fourteen studies (total population of 1,625) published from 1974 to 2008 were included. In general surgery, the pooled rate of all-sites proximal, isolated distal DVT was 13.4, 2.1, and 11.8 % (radionucleotide scan). The cancer patients carried a higher all-sites DVT rate (19.7 % radionucleotide scan and 17.4 % ultrasound). Gynecologic and neurologic surgery had 3.1 % (ultrasound) and 3.8 % (radionucleotide scan) all-sites DVT rate. For general, gynecologic, and neurologic patients, the pooled rates of symptomatic DVT were 1.5, 0.2, and 1.0 % respectively. The pooled rate of symptomatic pulmonary embolism (PE) was 0.4 % for general surgery. No patients died from PE (pooled rate 0.2 %); however, a single PE death was reported in the excluded study.
Postoperative symptomatic VTE was relatively low in Asia. Further study is required to stratify VTE risk and the need for thromboprophylaxis in individual patients.
一般妇科和神经外科手术被认为具有中度术后静脉血栓栓塞（VTE）风险。本研究分析了亚洲这些手术的术后 VTE 发生率。
纳入标准为：前瞻性研究；通过静脉造影、超声或放射性核素扫描诊断深静脉血栓形成（DVT）；且无血栓预防。使用随机效应模型，通过 Freeman-Tukey 变体变换从荟萃分析中反推合并比例。
检索了 Medline、EMBASE、Cochrane 图书馆和 KoreaMed。共纳入了 1974 年至 2008 年发表的 14 项研究（总人群 1625 人）。在普通外科手术中，所有部位近端、孤立的远端 DVT 的合并发生率分别为 13.4%、2.1%和 11.8%（放射性核素扫描）。癌症患者的所有部位 DVT 发生率更高（放射性核素扫描 19.7%，超声 17.4%）。妇科和神经外科手术的所有部位 DVT 发生率分别为 3.1%（超声）和 3.8%（放射性核素扫描）。对于普通外科、妇科和神经科患者，症状性 DVT 的合并发生率分别为 1.5%、0.2%和 1.0%。普通外科手术症状性肺栓塞（PE）的合并发生率为 0.4%。没有患者死于 PE（合并发生率 0.2%）；然而，排除的研究中报告了一例单独的 PE 死亡。
亚洲术后症状性 VTE 相对较低。需要进一步研究来分层个体患者的 VTE 风险和血栓预防的必要性。
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