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微创结直肠癌手术后术后静脉血栓栓塞的预测因素：一项回顾性观察研究。

Predictive factors on postoperative venous thromboembolism after minimally invasive colorectal cancer surgery: a retrospective observational study.

机构信息

Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.

出版信息

BMC Surg. 2023 Apr 11;23(1):85. doi: 10.1186/s12893-023-01992-x.

DOI:10.1186/s12893-023-01992-x
PMID:37041489
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10091640/
Abstract

BACKGROUND

Venous thromboembolism (VTE) is a serious and preventable postoperative complication. However, the predictive significance of perioperative biochemical parameters for VTE after minimally invasive colorectal cancer surgery remains unclear.

METHODS

A total of 149 patients undergoing minimally invasive colorectal cancer surgery were collected between October 2021 and October 2022. Biochemical parameters related to preoperative and postoperative day 1, day 3, and day 5 were collected, including D-Dimer, mean platelet volume (MPV), and maximum amplitude (MA) of thromboelastography (TEG). Receiver operating characteristic (ROC) curves were used to explore the predictive powers of meaningful biochemical parameters for postoperative VTE, and calibration curves were used to assess predictive accuracy.

RESULTS

The overall cumulative incidence of VTE was 8.1% (12/149). The preoperative and postoperative day 3 D-Dimer, postoperative day 3, and day 5 MPV, and postoperative day 1, day 3, and day 5 TEG-MA was significantly higher in the VTE group than in the non-VTE group (P < 0.05). The results of both the ROC curve and the calibration curve indicated that these meaningful D-Dimer, MPV, and TEG-MA had moderate discrimination and consistency for postoperative VTE.

CONCLUSIONS

D-Dimer, MPV, and TEG-MA may predict postoperative VTE in patients undergoing minimally invasive surgery for colorectal cancer at specific times in the perioperative period.

摘要

背景

静脉血栓栓塞症（VTE）是一种严重且可预防的术后并发症。然而，微创结直肠癌手术后围手术期生化参数对 VTE 的预测意义尚不清楚。

方法

收集 2021 年 10 月至 2022 年 10 月期间 149 例行微创结直肠癌手术的患者。收集与术前和术后第 1、3、5 天相关的生化参数，包括 D-二聚体、平均血小板体积（MPV）和血栓弹力图（TEG）的最大振幅（MA）。受试者工作特征（ROC）曲线用于探讨有意义的生化参数对术后 VTE 的预测能力，并使用校准曲线评估预测准确性。

结果

VTE 的总累积发生率为 8.1%（12/149）。VTE 组的术前和术后第 3 天 D-二聚体、术后第 3 天和第 5 天 MPV 以及术后第 1、3 和 5 天 TEG-MA 均显著高于非 VTE 组（P<0.05）。ROC 曲线和校准曲线的结果均表明，这些有意义的 D-二聚体、MPV 和 TEG-MA 在特定时间对结直肠癌微创手术患者的术后 VTE 具有中度的鉴别力和一致性。

结论

D-二聚体、MPV 和 TEG-MA 可能预测微创结直肠癌手术患者围手术期特定时间的术后 VTE。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a854/10091640/0ab5fed2ab96/12893_2023_1992_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a854/10091640/49afb805b693/12893_2023_1992_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a854/10091640/a6b17fe252c9/12893_2023_1992_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a854/10091640/0ab5fed2ab96/12893_2023_1992_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a854/10091640/49afb805b693/12893_2023_1992_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a854/10091640/a6b17fe252c9/12893_2023_1992_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a854/10091640/0ab5fed2ab96/12893_2023_1992_Fig3_HTML.jpg

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