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腹部癌症大手术后围手术期短期预防深静脉血栓形成:回顾性队列研究

Perioperative Short Term Prophylaxis against Deep Vein Thrombosis after Major Abdominal Cancer Surgery: Retrospective Cohort Study.

作者信息

Colapkulu-Akgul Nuray, Ozemir Ibrahim Ali, Beyazadam Damla, Alimoglu Orhan

机构信息

Department of General Surgery, Kocaeli Gebze Fatih Public Hospital, Kocaeli, Turkey.

Department of General Surgery, Istanbul Medeniyet University, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey.

出版信息

Vasc Specialist Int. 2021 Dec 31;37:45. doi: 10.5758/vsi.210065.

Abstract

PURPOSE

The aim of this study is to evaluate the outcomes of pharmacological thromboprophylaxis given for short-term duration to the patients who underwent major abdominal surgery for colorectal and gastric cancer.

MATERIALS AND METHODS

This retrospective cohort study was performed in consecutive patients who underwent major abdominal surgery for colorectal and gastric cancer and received short-term pharmacological thromboprophylaxis during hospital stay were enrolled. Complete duplex ultrasonography of the lower limbs was performed for all patients to investigate both symptomatic and asymptomatic deep vein thrombosis (DVT).

RESULTS

Overall, 278 patients were evaluated for inclusion and 62 colorectal and 27 gastric cancer patients were enrolled. Of 89 patients, the incidence of total and symptomatic DVT was 4.5% and 2.2%, respectively. The patients with symptomatic DVT were diagnosed within the first four months. The incidence of coronary artery disease, mucinous adenocarcinoma and vascular tumor invasion were significantly higher in patients with DVT (P-values<0.001, 0.009, and 0.02, respectively).

CONCLUSION

Short-term pharmacological thromboprophylaxis after major abdominal surgery for colorectal and gastric cancer does not increase symptomatic DVT rates of patients with low Caprini score. Postoperative DVT surveillance may benefit patients with coronary artery disease, mucinous adenocarcinoma or vascular invasion of the tumor.

摘要

目的

本研究旨在评估对接受结直肠癌和胃癌大腹部手术的患者进行短期药物性血栓预防的效果。

材料与方法

本回顾性队列研究纳入了连续接受结直肠癌和胃癌大腹部手术且住院期间接受短期药物性血栓预防的患者。对所有患者进行下肢完整的双功超声检查,以调查有症状和无症状的深静脉血栓形成(DVT)。

结果

总体而言,对278例患者进行了纳入评估,其中62例结直肠癌患者和27例胃癌患者被纳入研究。在89例患者中,总DVT和有症状DVT的发生率分别为4.5%和2.2%。有症状DVT的患者在头四个月内被诊断出来。DVT患者的冠状动脉疾病、黏液腺癌和血管肿瘤侵犯的发生率显著更高(P值分别<0.001、0.009和0.02)。

结论

结直肠癌和胃癌大腹部手术后的短期药物性血栓预防不会增加Caprini评分低的患者的有症状DVT发生率。术后DVT监测可能使患有冠状动脉疾病、黏液腺癌或肿瘤血管侵犯的患者受益。

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Venous thromboembolism and cancer risk.静脉血栓栓塞与癌症风险。
J Thromb Thrombolysis. 2017 Jan;43(1):68-73. doi: 10.1007/s11239-016-1411-y.

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