Third Department of Internal Medicine, National and Kapodistrian University of Athens, Thoracic Diseases General Hospital Sotiria, Athens, Greece.
Department of Otorhinolaryngology, Head and Neck Surgery, General Hospital of Nikaia-Piraeus, Athens, Greece.
Curr Pharm Des. 2022;28(10):787-797. doi: 10.2174/1381612828666220217140639.
Venous thromboembolism (VTE) is a term used to compositely describe deep vein thrombosis (DVT) and pulmonary embolism (PE). Overall, the incidence of VTE after major abdominal and pelvic surgery has been reported to be between 10% and 40%.
The aim of this study is to estimate the incidence of post-operative VTE in patients undergoing major abdominal surgery for cancer, to identify risk factors associated with VTE, and to assess available thromboprophylaxis tools.
A Medline and Cochrane literature search from database inception until February 1st, 2021 was performed according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines.
Thirty-one studies met our eligibility criteria and were included in the current review. In total, 435,492 patients were identified and the overall incidence of VTE was 2.19% (95% CI: 1.82-2.38). Τhe following risk factors were associated with VTE: smoking, advanced age (>70 years), a history of diabetes mellitus, American Society of Anesthesiologists' (ASA) classification of Physical Health class III or IV, a history of cardiovascular or pulmonary disease, a history of DVT or PE, elevated plasma fibrinogen level, c-reactive protein (CRP) level, cancer stage III or IV, postoperative acute respiratory distress syndrome (ARDS), prolonged postoperative hospital stay, previous steroid use, history of Inflammatory Bowel Disease (IBD), heart failure and neoadjuvant and adjuvant chemotherapy.
VTE remains an important complication after major abdominal surgery for cancer and seems to increase mortality rates.
静脉血栓栓塞症（VTE）是一个综合术语，用于描述深静脉血栓形成（DVT）和肺栓塞（PE）。总体而言，大型腹部和骨盆手术后 VTE 的发生率为 10%至 40%。
本研究旨在估计接受大型腹部癌症手术的患者术后 VTE 的发生率，确定与 VTE 相关的危险因素，并评估现有的血栓预防工具。
根据 PRISMA（系统评价和荟萃分析的首选报告项目）指南，对从数据库创建开始到 2021 年 2 月 1 日的 Medline 和 Cochrane 文献进行了搜索。
符合纳入标准的 31 项研究被纳入本综述。总共确定了 435,492 名患者，VTE 的总体发生率为 2.19%（95%CI：1.82-2.38）。以下风险因素与 VTE 相关：吸烟、年龄较大（>70 岁）、糖尿病史、美国麻醉医师协会（ASA）身体状况分级 III 或 IV、心血管或肺部疾病史、DVT 或 PE 史、血浆纤维蛋白原水平升高、C 反应蛋白（CRP）水平升高、癌症 III 或 IV 期、术后急性呼吸窘迫综合征（ARDS）、术后住院时间延长、既往使用类固醇、炎症性肠病（IBD）史、心力衰竭和新辅助和辅助化疗。
VTE 仍然是癌症大型腹部手术后的一个重要并发症，似乎会增加死亡率。
