Department of General Surgery, Division of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China.
Int J Surg. 2023 Sep 1;109(9):2689-2695. doi: 10.1097/JS9.0000000000000429.
Venous thromboembolism (VTE) is a common postoperative complication; however, the incidence and risk stratification of postoperative VTE in patients with retroperitoneal tumor remains unclear. The authors aim to quantify the incidence, identify risk factors, and determine the outcomes of VTE in patients undergoing retroperitoneal tumor surgery.
The authors retrospectively reviewed the characteristics, perioperative outcomes, and overall survival (OS) of patients (VTE and non-VTE) who underwent retroperitoneal tumor surgery between 2015 and 2020. Perioperative and oncologic outcomes were compared using propensity-matching and Cox analyses.
Of 1223 patients with retroperitoneal tumor surgery, 2.1% had VTE. Age [odds ratio (OR) 1.140, 95% CI: 1.053-1.239, P =0.004], recurrence (OR 1.851, 95% CI: 1.241-2.761, P =0.003), and vascular resection (OR 2.036, 95% CI: 1.054-3.934, P =0.034) were independent risk factors, with significant between-group differences regarding age, recurrence, sarcoma, organ resection, vascular resection, and operation time. No between-group differences in 30-day all-cause mortality (8 vs. 4%, OR 0.657, 95% CI: 0.375-1.151, P =0.427) and major complications (12 vs. 8%, OR 0.775, 95% CI: 0.483-1.244, P =0.572) were observed. Mean hospitalization duration (20.1 vs. 22.9 days, OR 1.153, 95% CI: 1.022-1.386, P =0.033) and ICU stay (3.2 vs. 5.5 days, OR 1.193, 95% CI: 1.034-1.347, P =0.012) were shorter in non-VTE versus VTE, respectively, with inferior OS (hazard ratio 2.090, 95% CI: 1.014-4.308, P =0.046) in VTE.
Age, recurrence, and vascular resection are positively associated with VTE, which is associated with inferior OS.
静脉血栓栓塞症（VTE）是一种常见的术后并发症；然而，腹膜后肿瘤患者术后 VTE 的发生率和风险分层仍不清楚。作者旨在量化腹膜后肿瘤手术患者 VTE 的发生率，确定其风险因素，并评估 VTE 的结局。
作者回顾性分析了 2015 年至 2020 年间接受腹膜后肿瘤手术的患者（VTE 和非 VTE）的特征、围手术期结局和总生存（OS）。采用倾向匹配和 Cox 分析比较围手术期和肿瘤学结局。
在 1223 例腹膜后肿瘤手术患者中，2.1%发生 VTE。年龄（优势比 [OR] 1.140，95%置信区间：1.053-1.239，P =0.004）、复发（OR 1.851，95%置信区间：1.241-2.761，P =0.003）和血管切除（OR 2.036，95%置信区间：1.054-3.934，P =0.034）是独立的风险因素，两组在年龄、复发、肉瘤、器官切除、血管切除和手术时间方面存在显著差异。两组 30 天全因死亡率（8% vs. 4%，OR 0.657，95%置信区间：0.375-1.151，P =0.427）和主要并发症（12% vs. 8%，OR 0.775，95%置信区间：0.483-1.244，P =0.572）无显著差异。非 VTE 组的平均住院时间（20.1 天 vs. 22.9 天，OR 1.153，95%置信区间：1.022-1.386，P =0.033）和 ICU 停留时间（3.2 天 vs. 5.5 天，OR 1.193，95%置信区间：1.034-1.347，P =0.012）分别较短，VTE 患者的 OS 更差（风险比 2.090，95%置信区间：1.014-4.308，P =0.046）。
年龄、复发和血管切除与 VTE 呈正相关，VTE 与 OS 较差相关。
