Department of Thoracic Surgery, The Affiliated Brain Hospital of Nanjing Medical University (South Branch, Nanjing Chest Hospital), Nanjing, China.
Asia Pac J Clin Oncol. 2021 Oct;17(5):e142-e152. doi: 10.1111/ajco.13386. Epub 2020 Oct 2.
Venous thromboembolism (VTE) is a significant and preventable cause of mortality and morbidity in thoracic surgery. It usually deep venous thromboembolism (DVT) and pulmonary thromboembolism (PE). We conducted this article to perform a systematic review on prophylaxis of perioperative VTE in patients undergoing thoracic surgery especially lung surgery and esophageal surgery and to identify potential areas for future research.
The systematic review we conducted included studies of patients undergoing thoracic surgery especially lung surgery and esophageal surgery RESULTS: The study identified 2621 references. Finally, 22 trials with a total of 9072 patients were included. Only six studies declared that they continued a follow-up after the discharge of the patients. (range: 1-3 months); three studies reported on major bleeding events as an outcome measure, and the incidence varied from 0.8% to 1.6%. Total 346 VTEs occurred, and the overall mean risk of VTE was estimated at 3.8% (range: 0.77-27%).
The evidence for using thromboprophylaxis in thoracic surgery is limited and controversial, predominantly based on clinical consensus. Future research is needed to focus on identifying risk of VTE and providing sufficient evidence with high quality to support clinical strategies concerning the prophylaxis for VTE.
静脉血栓栓塞症（VTE）是胸外科，尤其是肺部和食管手术患者发生死亡和发病的一个重要且可预防的原因。VTE 通常包括深静脉血栓形成（DVT）和肺血栓栓塞症（PE）。我们开展本文旨在对接受胸外科手术（尤其是肺和食管手术）的患者进行围手术期 VTE 预防进行系统评价，并确定未来研究的潜在领域。
我们进行的系统评价包括对接受胸外科手术（尤其是肺和食管手术）的患者进行的研究。
该研究共检索到 2621 篇参考文献，最终纳入 22 项试验，共 9072 例患者。仅有 6 项研究在患者出院后继续进行了随访（范围：1-3 个月）；3 项研究将主要出血事件作为结局指标进行了报道，发生率从 0.8%到 1.6%不等。共发生 346 例 VTE，总体 VTE 发生率估计为 3.8%（范围：0.77%-27%）。
目前，有关在胸外科手术中使用血栓预防措施的证据有限且存在争议，主要基于临床共识。未来的研究需要重点关注识别 VTE 的风险，并提供高质量的充分证据，以支持有关 VTE 预防的临床策略。
