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腹部身体塑形手术后预防静脉血栓栓塞症的利伐沙班安全性:600 例患者。

Safety of Rivaroxaban for Postoperative Venous Thromboembolism Prophylaxis Following Abdominal Body Contouring Surgery: 600 Patients.

机构信息

Division of Plastic Surgery, University of North Carolina Atrium Health, Charlotte, NC, USA.

出版信息

Aesthet Surg J. 2021 May 18;41(6):674-681. doi: 10.1093/asj/sjaa177.

DOI:10.1093/asj/sjaa177
PMID:32582933
Abstract

BACKGROUND

Reducing the incidence of venous thromboembolism (VTE) following abdominal body contouring surgery remains a top priority for patient safety. There is a lack of consensus regarding the optimal chemoprophylactic agent for postoperative VTE prophylaxis, and the role of oral anticoagulants warrants further investigation.

OBJECTIVES

The aim of this multisurgeon, single-institution study was to determine the safety and efficacy of a 7-day postoperative rivaroxaban regimen for VTE prophylaxis in abdominal body contouring surgery.

METHODS

A retrospective chart review was performed of all patients who underwent abdominoplasty, circumferential body lift, fleur-de-lis panniculectomy, or circumferential fleur-de-lis panniculectomy at our surgical center from August 2014 to November 2019. A 7-day postoperative course of once-daily 10 mg rivaroxaban, starting on postoperative day 1, was administered to every patient unless there was a contraindication. The 2 primary endpoints were the incidence of VTE and bleeding events.

RESULTS

A total of 600 patients were included in the study. There were no deaths. There were 4 (0.7%) incidents of VTE events: 2 (0.3%) patients suffered pulmonary embolus and 2 (0.3%) patients suffered a lower-extremity deep venous thrombosis. A total of 13 (2.2%) patients suffered complications related to bleeding. Of these, operative intervention for control and evacuation was required in 7 (1.2%) patients.

CONCLUSIONS

A 7-day postoperative course of once-daily rivaroxaban for VTE risk reduction in abdominal body contouring surgery is associated with a low incidence of VTE events and a low risk of bleeding complications.

摘要

背景

降低腹部身体塑形手术后静脉血栓栓塞症(VTE)的发生率仍然是患者安全的首要任务。对于术后 VTE 预防的最佳化学预防药物尚未达成共识,口服抗凝剂的作用需要进一步研究。

目的

本多外科医生、单机构研究的目的是确定腹部身体塑形手术后使用利伐沙班进行 7 天术后 VTE 预防的安全性和有效性。

方法

对 2014 年 8 月至 2019 年 11 月在我们外科中心接受腹部整形术、环形身体提升术、fleur-de-lis 腹带切除术或环形 fleur-de-lis 腹带切除术的所有患者进行回顾性图表审查。每位患者术后第 1 天开始接受为期 7 天的每日 10 毫克利伐沙班治疗,除非有禁忌症。主要终点是 VTE 和出血事件的发生率。

结果

共有 600 例患者纳入研究。无死亡病例。发生 4 例(0.7%)VTE 事件:2 例(0.3%)患者发生肺栓塞,2 例(0.3%)患者发生下肢深静脉血栓形成。共有 13 例(2.2%)患者发生与出血相关的并发症。其中,7 例(1.2%)患者需要手术干预以控制和清除。

结论

腹部身体塑形手术后使用利伐沙班进行 7 天术后 VTE 风险降低与 VTE 事件发生率低和出血并发症风险低相关。

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