van Cruchten Stijn, Wong-Lun-Hing Edgar M, Reijnen Michel M P J, de Roos Marnix A J
Department of Gastrointenstinal and Oncological Surgery, Rijnstate Hospital, Arnhem, the Netherlands.
Department of Vascular Surgery, Rijnstate Hospital, Arnhem, the Netherlands.
Res Pract Thromb Haemost. 2025 May 17;9(4):102886. doi: 10.1016/j.rpth.2025.102886. eCollection 2025 May.
Venous thromboembolism (VTE) is a rare complication after colorectal cancer surgery, but may have a devastating outcome. The goal of this study was to report the incidence of VTE in our practice and identify predictors of VTE after colorectal resection for cancer.
This was a single-center retrospective cohort analysis. We used the hospital-specific Dutch Colorectal Audit database to identify patients that underwent oncologic colorectal resection between 2015 and 2022 and subsequently developed a VTE. Patients who used therapeutic anticoagulants postoperatively due to pre-existing conditions were excluded. During the study period, VTE prophylaxis was applied according to the local protocol. Patient characteristics and postoperative data were extracted from the patient records.
Overall, 1261 patients were included, of which 13 patients developed VTE (1.0%). All cases involved pulmonary embolism. One patient (7.7%) had a simultaneous deep venous thrombosis. There were no deaths due to VTE. The incidence of other complications was significantly higher in patients with VTE (84.6% vs 28.5%; ≤ .001). Multivariable logistic regression analysis indicated that the occurrence of an infectious complication was an independent predictor of VTE (odds ratio, 7.95; 95% CI, 2.20-28.69). Other variables that have previously been connected to the occurrence of VTE have been analyzed, but no other independent predictors were identified.
An infectious complication may be an independent predictor of the development of VTE. The necessity of prolonged prophylaxis after oncologic colorectal resections remains unclear.
静脉血栓栓塞症（VTE）是结直肠癌手术后一种罕见的并发症，但可能产生严重后果。本研究的目的是报告我们实践中VTE的发生率，并确定结直肠癌切除术后VTE的预测因素。
这是一项单中心回顾性队列分析。我们使用特定医院的荷兰结直肠癌审计数据库来识别2015年至2022年间接受肿瘤性结直肠癌切除术并随后发生VTE的患者。因既往疾病术后使用治疗性抗凝剂的患者被排除。在研究期间，根据当地方案进行VTE预防。从患者记录中提取患者特征和术后数据。
总体而言，纳入了1261例患者，其中13例发生VTE（1.0%）。所有病例均涉及肺栓塞。1例患者（7.7%）同时发生深静脉血栓形成。没有因VTE导致的死亡。VTE患者中其他并发症的发生率显著更高（84.6%对28.5%；P≤.001）。多变量逻辑回归分析表明，感染性并发症的发生是VTE的独立预测因素（比值比，7.95；95%CI，2.20 - 28.69）。对先前与VTE发生相关的其他变量进行了分析，但未发现其他独立预测因素。
感染性并发症可能是VTE发生的独立预测因素。肿瘤性结直肠癌切除术后延长预防的必要性仍不清楚。
