Guirgis Mina, Keelan Simon, McEntee Philip, Han Margaret, Moroz Paul
Department of General Surgery, Joondalup Health Campus, Perth, Western Australia, Corner Grant Boulevard & Shenton Avenue, Joondalup, Western Australia, Australia, 6027.
Western Australian Peritonectomy Service, Joondalup Health Campus, Perth, Western Australia, Suite 24-26 Specialist Medical Centre East, Level 2 Joondalup Private Hospital, 60 Shenton Avenue, Joondalup, Western Australia, Australia, 6027.
Surg Pract Sci. 2024 Jul 14;18:100257. doi: 10.1016/j.sipas.2024.100257. eCollection 2024 Sep.
Cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC) represent a high-risk for venous thromboembolism (VTE) due to malignancy, prolonged surgery and immobility. We investigated the incidence of and risk factors for VTE following CRS/IPC.
Data was analysed on 130 CRS/IPC performed over a 6-year period at a single centre, the Western Australian Peritonectomy Service (WAPS), on lower gastrointestinal neoplasia: pseudomyxoma peritoneii (PMP), colorectal cancer (CRC) and appendix cancer (AC). Data was analysed by univariate and multivariate logistic regression to identify risk factors for VTE.
31 patients (24 %) experienced a VTE. The percentages of VTE among patients with PMP ( = 50), CRC ( = 53) and AC ( = 27) were 36 %, 17 % and 15 % respectively. 60 % of these cases were asymptomatic. The odds of VTE were higher for PMP patients than in patients with a other histopathology (OR=2.9, = 0.01). Other significant risk factors for VTE on univariate analysis were PCI (OR=1.07, = 0.001), pelvic dissection (OR=5.52, = 0.001) and operation time (OR=1.36, = 0.001).
This study demonstrates high rates of VTE in patients undergoing CRS/IPC. Patients with PMP have a three-fold higher risk of VTE compared to other malignancies (CRC+AC). As most VTE cases were asymptomatic, aggressive early investigation and intervention is indicated for patients undergoing CRS/IPC.
减瘤手术（CRS）和腹腔内化疗（IPC）因恶性肿瘤、手术时间延长和活动减少而具有静脉血栓栓塞（VTE）的高风险。我们调查了CRS/IPC后VTE的发生率及危险因素。
对西澳大利亚腹膜切除术服务中心（WAPS）在6年期间对130例下消化道肿瘤（腹膜假黏液瘤（PMP）、结直肠癌（CRC）和阑尾癌（AC））患者进行的CRS/IPC数据进行分析。通过单因素和多因素逻辑回归分析数据以确定VTE的危险因素。
31例患者（24%）发生VTE。PMP患者（n = 50）、CRC患者（n = 53）和AC患者（n = 27）中VTE的发生率分别为36%、17%和15%。这些病例中有60%无症状。PMP患者发生VTE的几率高于其他组织病理学患者（OR = 2.9，P = 0.01）。单因素分析中其他VTE的显著危险因素为PCI（OR = 1.07，P = 0.001）、盆腔清扫术（OR = 5.52，P = 0.001）和手术时间（OR = 1.36，P = 0.001）。
本研究表明接受CRS/IPC的患者VTE发生率较高。与其他恶性肿瘤（CRC+AC）相比，PMP患者发生VTE的风险高三倍。由于大多数VTE病例无症状，对于接受CRS/IPC的患者，应积极进行早期检查和干预。
