Shu Liang, Xia Cheng-Wei, Pang Yu-Fan
Department of Thyroid Surgery, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China.
World J Gastrointest Surg. 2024 Oct 27;16(10):3269-3276. doi: 10.4240/wjgs.v16.i10.3269.
Deep vein thrombosis (DVT) is a significant postoperative concern, particularly in patients undergoing surgery for gastrointestinal (GI) cancers. These patients often present multiple risk factors, including advanced age and elevated body mass index (BMI), which can increase the likelihood of thromboembolic events. Effective prophylaxis is crucial in this high-risk population to minimize complications such as DVT and pulmonary embolism (PE). This study investigates a comprehensive DVT prevention protocol, combining mechanical and pharmacological strategies alongside early mobilization, to evaluate its effectiveness and safety in reducing postoperative thrombosis rates among GI cancer surgery patients.
To evaluate the effectiveness and safety of postoperative DVT prevention strategies in patients with GI cancer.
A prospective cohort study was conducted involving 100 patients who underwent surgery for GI tumors between January and December 2022. All patients received a standardized DVT prevention protocol, which included risk assessment, mechanical prophylaxis, pharmacological prophylaxis, and early mobilization. The primary endpoint was the incidence of DVT within 30 days postoperatively. Secondary outcomes included the occurrence of PE, bleeding complications, and adherence to the protocol.
The overall incidence of DVT was 7% (7/100 patients). One patient (1%) developed PE. The adherence rate to the prevention protocol was 92%. Bleeding complications were observed in 3% of patients. Significant risk factors for DVT development included advanced age [odds ratio (OR): 1.05; 95% confidence interval (95%CI): 1.01-1.09], higher BMI (OR: 1.11; 95%CI: 1.03-1.19), and longer operative time (OR: 1.007; 95%CI: 1.001-1.013).
Implementing a comprehensive DVT prevention and management protocol for patients undergoing GI tumor surgery resulted in a lower incidence. Strict adherence and individualized risk assessment are crucial for optimizing outcomes.
深静脉血栓形成(DVT)是术后的一个重要问题,尤其是在接受胃肠道(GI)癌手术的患者中。这些患者通常存在多种风险因素,包括高龄和体重指数(BMI)升高,这会增加血栓栓塞事件的可能性。在这个高危人群中,有效的预防措施对于将DVT和肺栓塞(PE)等并发症的发生风险降至最低至关重要。本研究调查了一种综合的DVT预防方案,该方案结合了机械和药物策略以及早期活动,以评估其在降低GI癌手术患者术后血栓形成率方面的有效性和安全性。
评估GI癌患者术后DVT预防策略的有效性和安全性。
进行了一项前瞻性队列研究,纳入了2022年1月至12月期间接受GI肿瘤手术的100例患者。所有患者均接受标准化的DVT预防方案,包括风险评估、机械预防、药物预防和早期活动。主要终点是术后30天内DVT的发生率。次要结局包括PE的发生、出血并发症以及对方案的依从性。
DVT的总体发生率为7%(7/100例患者)。1例患者(1%)发生了PE。预防方案的依从率为92%。3%的患者出现了出血并发症。DVT发生的显著风险因素包括高龄[比值比(OR):1.05;95%置信区间(95%CI):1.01 - 1.09]、较高的BMI(OR:1.11;95%CI:1.03 - 1.19)和较长的手术时间(OR:1.007;95%CI:1.001 - 1.013)。
为接受GI肿瘤手术的患者实施综合的DVT预防和管理方案可降低发生率。严格的依从性和个体化的风险评估对于优化结局至关重要。