Hayes Joshua W, Ryan Éanna J, Boland Patrick A, Creavin Ben, Kelly Michael E, Beddy David
Department of Surgery, James Connolly Memorial Hospital, Blanchardstown, Dublin, Ireland.
Int J Colorectal Dis. 2019 May;34(5):849-860. doi: 10.1007/s00384-019-03244-y. Epub 2019 Mar 1.
Venous thromboembolism (VTE) following rectal surgery is a significant and preventable cause of morbidity and mortality, yet the true prevalence is not well established. This systematic review and meta-analysis assessed the available literature and determined its prevalence following rectal surgery.
A systematic review assessed the prevalence of VTE following rectal surgery. In addition, we evaluated whether subgroups (open vs. minimally invasive or benign vs. malignant resections) impacted on its prevalence or rate of deep venous thrombosis (DVT) or pulmonary embolism (PE).
Thirty-eight studies met the predefined inclusion criteria. The aggregate prevalence of VTE following rectal surgery was 1.25% (95% CI 0.86-1.63), with DVT and PE occurring in 0.68% (95% CI 0.48-0.89) and 0.57% (95% CI 0.47-0.68) of patients. VTE following cancer and benign resection was 1.59% (95% CI 0.60-1.23 and 1.5% (95% CI 0.89-2.12) respectively. The prevalence of VTE in patients having minimally invasive resection was lower than those having open surgery [0.58% (16/2770) vs. 2.22% (250/11278); RR 0.54, 95% CI 0.33-0.86].
This review observed that there is sparse evidence on prevalence of VTE following rectal surgery. It provides aggregated data and analysis of available literature, showing overall prevalence is low, especially in those having minimally invasive procedures.
直肠手术后静脉血栓栓塞症（VTE）是发病率和死亡率的一个重要且可预防的原因，但其真实患病率尚未完全明确。本系统评价和荟萃分析评估了现有文献，并确定了直肠手术后VTE的患病率。
一项系统评价评估了直肠手术后VTE的患病率。此外，我们评估了亚组（开放手术与微创手术或良性与恶性切除术）是否会影响其患病率或深静脉血栓形成（DVT）或肺栓塞（PE）的发生率。
38项研究符合预先设定的纳入标准。直肠手术后VTE的总体患病率为1.25%（95%CI 0.86-1.63），DVT和PE分别发生在0.68%（95%CI 0.48-0.89）和0.57%（95%CI 0.47-0.68）的患者中。癌症和良性切除术后的VTE分别为1.59%（95%CI 0.60-1.23）和1.5%（95%CI 0.89-2.12）。接受微创手术的患者中VTE的患病率低于接受开放手术的患者[0.58%（16/2770）对2.22%（250/11278）；RR 0.54，95%CI 0.33-0.86]。
本评价发现关于直肠手术后VTE患病率的证据稀少。它提供了现有文献的汇总数据和分析，表明总体患病率较低，尤其是在接受微创手术的患者中。
