Deep vein thrombosis and pulmonary embolism following lung resection

Abstract

Deep vein thrombosis (DVT) and pulmonary embolism (PE) are common complications in cancer. Patients with lung cancer have a risk of venous thromboembolism (VTE) of around 3% over 2 years.The incidence of DVT after thoracic surgery is estimated to be between 0.4% and 51% and the incidence of PE between 1% and 5%. The risk factors for VTE may be patient-related, cancer-related or treatmentrelated. Pneumonectomy is associated with a 3-fold increase in post discharge VTE events compared to lobectomy. The diagnosis of VTE may be challenging as it has few specific symptoms. For this reason, prophylactic treatment with low molecular weight heparin or unfractioned heparin and antiembolism stockings or intermittent pneumatic compression devices are widely recommended for patients at risk for VTE. Patients who undergo thoracic surgery are deemed at high risk for postoperative VTE as a significant proportion of them have cancer, underlying respiratory and cardiovascular comorbidities, and are of advanced age. Extended VTE prophylaxis may be considered as there is a risk of developing VTE post discharge. Risk-assessment models for VTE can be utilized in thoracic surgery and the Caprini riskassessment model has been used successfully in the USA. Postoperative PE needs to be diagnosed and treated promptly as delay may be fatal. It is managed with anticoagulants but thrombolysis should be considered in compromised patients.

Thoracic Surgery and the Elderly: Is Lobectomy Safe in Octogenarians?

“…The estimated prevalence of pulmonary embolism (PE) post thoracic surgery ranges from 1%-5% [10]. We observed a rate of 0.34% and 1.66% in non-octogenarians and octogenarians, respectively (p=0.092).…”

FILET VEINEUX PROFONDE : IDENTIFICATION DE LA THROMBOSE VEINE PROFONDE VIA UN RÉSEAU D'APPRENTISSAGE PROFONDE OPTIMISÉ PAR LA STERNE fuligineuse

“…Up to 30% of DVT patients are symptom-free, while symptoms can be very minimal or no cause for concern [3]. Before the blood clot from the arm or leg reaches the lungs, some patients don't realize they have DVT [4]. Any age can experience severe DVT or PE.…”