Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kawaramachi Hirokoji Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
Langenbecks Arch Surg. 2022 May;407(3):1009-1016. doi: 10.1007/s00423-021-02367-7. Epub 2021 Nov 2.
Although a central venous catheter (CVC) is often needed perioperatively for intraoperative and nutritional management of esophageal cancer (EC), the catheter placement impacts the risk of venous thrombosis. We examined the risks of thrombus formation by catheter type, placement, and duration.
In total, 226 patients with EC were enrolled in this retrospective study. Patients were classified into one of three groups: those with a conventional CVC (cCVC), a peripherally inserted central catheter (PICC), or an antithrombogenic agent-coated PICC (secPICC). The thrombus formation and clinicopathological features were examined.
The frequency of all types of thrombosis was significantly lower in the secPICC group (p < 0.01). Although deep vein thrombosis was frequent in the cCVC group, catheter thrombosis was frequent in the PICC group. In a univariate analysis in patients with the PICC and secPICC groups, less thrombus formation was observed in the secPICC (p = 0.01), short placement time (p = 0.02), and right-sided placement (p < 0.01). Furthermore, a multivariate analysis revealed that secPICC (p = 0.049) and right-sided placement (p = 0.04) significantly reduced rates of thrombus formation.
In patients with EC, secPICC and right-sided placement reduce perioperative venous thrombus formation.
尽管中心静脉导管（CVC）通常在食管癌（EC）围手术期用于术中管理和营养支持，但导管放置会影响静脉血栓形成的风险。我们研究了导管类型、放置位置和时间对血栓形成风险的影响。
本回顾性研究共纳入 226 例食管癌患者。患者分为三组：常规 CVC（cCVC）组、经外周静脉置入中心静脉导管（PICC）组和抗血栓涂层 PICC（secPICC）组。检查了血栓形成和临床病理特征。
secPICC 组的所有类型血栓形成频率均显著降低（p<0.01）。虽然 cCVC 组深静脉血栓形成较为常见，但 PICC 组导管血栓形成较为常见。在 PICC 和 secPICC 组患者的单因素分析中，secPICC（p=0.01）、短时间放置（p=0.02）和右侧放置（p<0.01）的血栓形成较少。此外，多因素分析显示 secPICC（p=0.049）和右侧放置（p=0.04）显著降低了血栓形成率。
在食管癌患者中，secPICC 和右侧放置可减少围手术期静脉血栓形成。
