Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
Esophagus. 2024 Apr;21(2):150-156. doi: 10.1007/s10388-023-01038-4. Epub 2024 Jan 12.
Venous thrombosis (VT) after esophagectomy for esophageal cancer is an important complication, potentially leading to pulmonary embolism. However, there are few available information about the risk for the postsurgical VT.
This study included 271 patients who underwent esophagectomy for esophageal cancer between 2006 and 2019. Contrast-enhanced computed tomography (CT) was performed for all patients on the seventh postoperative day to survey complications, including VT.
VT was radiologically visualized in 48 patients (17.7%), 8 of whom (16.7%) had pulmonary embolism. The thrombus disappeared in 42 patients, the thrombus size was unchanged in 5 patients, and 1 patient died. Multivariate analysis was performed on factors clinically considered to have a significant influence on thrombus formation. The analysis showed that CVC insertion via the femoral vein (odds ratio, 7.67; 95% CI, 2.64-22.27; P < 0.001), retrosternal reconstruction route (odds ratio, 3.94; 95% CI, 1.90-8.17; P < 0.001) and intraoperative fluid balance < 5 ml/kg/hr (odds ratio, 0.38; 95% CI, 0.17-0.85; P = 0.019) were independently related to VT.
Intraoperative fluid balance < 5 ml/kg/hr, along with CVC insertion via the femoral vein and retrosternal reconstruction may be potential risk factors for VT after esophagectomy.
食管癌手术后的静脉血栓（VT）是一种重要的并发症，可能导致肺栓塞。然而，有关手术后 VT 的风险的信息很少。
本研究纳入了 2006 年至 2019 年间接受食管癌切除术的 271 例患者。所有患者均在术后第 7 天行增强 CT 以调查并发症，包括 VT。
48 例（17.7%）患者影像学上可见 VT，其中 8 例（16.7%）有肺栓塞。42 例血栓消失，5 例血栓大小不变，1 例死亡。对临床上认为对血栓形成有显著影响的因素进行多因素分析。分析表明，经股静脉插入中心静脉导管（优势比，7.67；95%可信区间，2.64-22.27；P<0.001）、胸骨后重建途径（优势比，3.94；95%可信区间，1.90-8.17；P<0.001）和术中液体平衡<5ml/kg/hr（优势比，0.38；95%可信区间，0.17-0.85；P=0.019）是 VT 的独立相关因素。
术中液体平衡<5ml/kg/hr，以及经股静脉插入中心静脉导管和胸骨后重建可能是食管癌手术后 VT 的潜在危险因素。
