Yasui Masayoshi, Ikeda Masataka, Hata Taishi, Okamura Shu, Miyake Yasuhiro, Sakisaka Hideki, Takahashi Hidekazu, Miyoshi Norikatsu, Uemura Mamoru, Mizushima Tsunekazu, Yamamoto Hirofumi, Murata Kohei, Doki Yuichiro, Eguchi Hidetoshi
Department of Gastroenterological Surgery, Osaka International Cancer Institute, Otemae 3-1-69, Chuo-ku, Osaka, Japan.
Department of Surgery, Osaka National Hospital, Osaka, Japan.
Surg Today. 2022 Jun;52(6):881-888. doi: 10.1007/s00595-021-02422-2. Epub 2021 Nov 29.
Postoperative venous thromboembolism (VTE) is a major and potentially fatal postoperative complication of colorectal cancer surgery. However, there is uncertainty about the necessity for anticoagulant prophylaxis to prevent VTE after laparoscopic colorectal cancer surgery because of its associated relatively lower incidence. Currently, anticoagulant therapy is considered mainly for patients at high risk of the development of VTE. Focusing on proximal deep vein thrombosis (DVT)/ pulmonary embolism (PE), we aimed to identify those cases at high risk of the development of fatal VTE.
We performed an exploratory retrospective analysis to identify the risk factors for postoperative proximal DVT and PE after laparoscopic colorectal cancer surgery in patients included in our prospective trial.
A logistic regression analysis revealed factors that could predict the onset of proximal DVT/PE in patients with colorectal cancer. Blood loss and tumor location were identified as the predictors of proximal DVT/PE.
Patients with rectal cancer and those with excessive blood loss during colon cancer surgery must be monitored carefully for signs of VTE and especially proximal DVT/PE, after laparoscopic surgery.
术后静脉血栓栓塞症（VTE）是结直肠癌手术主要且潜在致命的术后并发症。然而，由于腹腔镜结直肠癌手术后VTE的发生率相对较低，对于抗凝预防措施预防VTE的必要性存在不确定性。目前，抗凝治疗主要针对VTE发生风险高的患者。聚焦于近端深静脉血栓形成（DVT）/肺栓塞（PE），我们旨在识别那些发生致命VTE风险高的病例。
我们进行了一项探索性回顾性分析，以确定纳入我们前瞻性试验的患者在腹腔镜结直肠癌手术后发生术后近端DVT和PE的危险因素。
逻辑回归分析揭示了可预测结直肠癌患者近端DVT/PE发病的因素。失血和肿瘤位置被确定为近端DVT/PE的预测因素。
直肠癌患者以及在结肠癌手术期间失血过多的患者，在腹腔镜手术后必须密切监测VTE的迹象，尤其是近端DVT/PE。
