Venous thromboembolism in patients undergoing unilateral partial pulmonary resection during hospitalization: a single-center retrospective study.

OBJECTIVE

– To review and analyze the clinical characteristics of patients experiencing venous thromboembolism(VTE) complications following unilateral partial pulmonary resection performed via video-assisted thoracoscopic surgery.

METHOD

• From January 2021 to December 2023, 44 cases were screened out from among 878 patients who underwent unilateral partial lung resection via thoracoscopy in our hospital. They were categorized into the VTE group ( = 11) and the non-VTE group ( = 33) based on whether thrombotic complications occurred after the surgery. VTE patients were diagnosed by performing a pulmonary artery CT scan and lower extremity vascular color Doppler ultrasound upon the occurrence of VTE symptoms. Non-VTE patients were system-matched cases with no confirmed evidence of VTE. All patients received venous thromboembolism (VTE) prophylaxis management during hospitalization, in accordance with established guidelines or expert consensus recommendations.

RESULTS

• A total of 44 patients were enrolled, of whom 38.6% were male, with a mean age of 62.7 years. Among them, 11 patients experienced thrombotic events, including 3 cases of deep vein thrombosis(DVT) and 11 cases of pulmonary embolism(PE), with no fatal cases. The incidence rate of thrombotic complications was 1.3%. Compared with the non-VTE group, patients in the VTE group exhibited a higher BMI, lower postoperative urine output, and a more pronounced increase in postoperative fibrinogen levels; all of these parameters demonstrated statistically significant differences. However, no significant differences were observed in Caprini scores between the two groups either preoperatively or postoperatively.

CONCLUSION

1. Postoperative venous thrombotic complications may be correlated with obesity, decreased postoperative urine output, and elevated postoperative fibrinogen levels. 2. The mean onset time of venous thromboembolism (VTE) occurred at 25.45 h post-surgery. Initiating low-molecular-weight heparin (LMWH) for VTE prophylaxis 24 h postoperatively may not be clinically appropriate. Given that this study was based on a retrospective analysis, whether these findings are universally applicable requires further investigation through prospective studies. 3. Symptomatic thrombotic complications in hospitalized patients following surgery predominantly present as pulmonary embolism (PE). 4. The predictive value of the Caprini score for assessing the risk of venous thrombosis following unilateral partial lung resection in patients with benign lung tumors or early-stage lung cancer appears to be limited.