Nakagawa Kazuya, Watanabe Jun, Suwa Yusuke, Suzuki Shinsuke, Ishibe Atsushi, Ota Mitsuyoshi, Kunisaki Chikara, Endo Itaru
Department of Surgery Gastroenterological Center Yokohama City University Medical Center Yokohama Japan.
Department of Gastroenterological Surgery Yokohama City University Graduate School of Medicine Yokohama Japan.
Ann Gastroenterol Surg. 2019 Apr 29;3(4):451-458. doi: 10.1002/ags3.12256. eCollection 2019 Jul.
Deep vein thrombosis (DVT) is a major complication of cancer. The postoperative prevalence of DVT in colorectal cancer (CRC) surgery is high, but the preoperative prevalence and the risk factors have not been clarified in detail. The objective of this retrospective study was to investigate the preoperative prevalence and risk factors of DVT in patients admitted to hospital for CRC surgery.
From January 2013 to March 2017, 1006 patients admitted for CRC surgery were deemed eligible for this retrospective study. Diagnosis of preoperative DVT was confirmed by compression ultrasonography. Prevalence of silent DVT in lower limbs in patients before CRC surgery was assessed, and the risk factors for preoperative DVT were investigated regarding the correlation of DVT with the patient's background.
Preoperative DVT and asymptomatic pulmonary thromboembolism were diagnosed in 136 (13.5%) and in 10 (1.0%) of 1006 patients overall, respectively. Multivariate analysis showed that increased age (≥75 years), female gender, and an elevated d-dimer level (>1.0 μg/mL) were independent risk factors for preoperative DVT in this study. Notably, the prevalence of preoperative DVT exceeded 50% in patients with all three predictors.
A high prevalence (13.5%) of preoperative DVT was found in patients admitted to the hospital for CRC surgery. The present results suggest that instrumental screening should be encouraged, at least in subgroups at a higher risk of preoperative DVT.
深静脉血栓形成(DVT)是癌症的主要并发症。结直肠癌(CRC)手术患者术后DVT的发生率较高,但术前发生率及危险因素尚未详细阐明。本回顾性研究的目的是调查因CRC手术入院患者术前DVT的发生率及危险因素。
2013年1月至2017年3月,1006例因CRC手术入院的患者被纳入本回顾性研究。术前DVT的诊断通过压迫超声检查确认。评估CRC手术患者术前下肢无症状DVT的发生率,并根据DVT与患者背景的相关性调查术前DVT的危险因素。
1006例患者中,分别有136例(13.5%)和10例(1.0%)被诊断为术前DVT和无症状肺栓塞。多因素分析显示,年龄增加(≥75岁)、女性以及D-二聚体水平升高(>1.0μg/mL)是本研究中术前DVT的独立危险因素。值得注意的是,具有所有这三个预测因素的患者术前DVT的发生率超过50%。
因CRC手术入院的患者术前DVT发生率较高(13.5%)。目前的结果表明,至少在术前DVT风险较高的亚组中,应鼓励进行器械筛查。