Incidence and risk factors for venous thromboembolism after laparoscopic surgery for colorectal cancer

Becattini, Cecilia; Rondelli, Fabio; Vedovati, Maria Cristina; Camporese, Giuseppe; Giustozzi, Michela; Boncompagni, Michela; Pucciarelli, Salvatore; Balzarotti, R.; Mariani, E.; Filippucci, Esmeralda; Donini, Annibale; Agnelli, Giancarlo

doi:10.3324/haematol.2014.109843

Cited by 27 publications

(6 citation statements)

References 15 publications

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“…The included studies are all relatively recent, thereby more accurately reflecting contemporary operative management, perioperative thromboprophylaxis protocols, and prevailing obesity rates among Asian patients. The overall pooled incidence of VTE for our 7 studies was 1.4%, which was lower than has been reported in Western-based studies, where incidence rates of 2.4% to 17% have been reported [26][27][28]. A systematic review conducted among Asian patients undergoing orthopedic surgery also reported similar trends [29].…”

Section: Discussionsupporting

confidence: 64%

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Venous thromboembolism among Asian populations with localized colorectal cancer undergoing curative resection: is pharmacological thromboprophylaxis required? A systematic review and meta-analysis

Tan,

et al. 2024

Ann Coloproctol

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We compared the incidence of venous thromboembolism (VTE) among Asian populations with localized colorectal cancer undergoing curative resection with and without the use of pharmacological thromboprophylaxis (PTP). Methods: A comprehensive literature search was undertaken to identify relevant studies published from January 1, 1980 to February 28, 2022. The inclusion criteria were patients who underwent primary tumor resection for localized nonmetastatic colorectal cancer; an Asian population or studies conducted in an Asian country; randomized controlled trials, case-control studies, or cohort studies; and the incidence of symptomatic VTE, deep vein thrombosis, and/or pulmonary embolism as the primary study outcomes. Data were pooled using a random-effects model. This study was registered in PROSPERO on October 11, 2020 (No. CRD42020206793). Results: Seven studies (2 randomized controlled trials and 5 observational cohort studies) were included, encompassing 5,302 patients. The overall incidence of VTE was 1.4%. The use of PTP did not significantly reduce overall VTE incidence: 1.1% (95% confidence interval [CI], 0%-3.1%) versus 1.9% (95% CI, 0.3%-4.4%; P = 0.55). Similarly, PTP was not associated with significantly lower rates of symptomatic VTE, proximal deep vein thrombosis, or pulmonary embolism. Conclusion:The benefit of PTP in reducing VTE incidence among Asian patients undergoing curative resection for localized colorectal cancer has not been clearly established. The decision to administer PTP should be evaluated on a case-by-case basis and with consideration of associated bleeding risks.

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Section: Discussionsupporting

confidence: 64%

“…Scores range from 0 to 28, with higher scores indicating a better methodological quality of study. The following cut-points have been suggested to categorize studies by quality: excellent (26)(27)(28), good (20)(21)(22)(23)(24)(25), fair (15)(16)(17)(18)(19), and poor ( < 14).…”

Section: Quality Assessmentmentioning

confidence: 99%

Venous thromboembolism among Asian populations with localized colorectal cancer undergoing curative resection: is pharmacological thromboprophylaxis required? A systematic review and meta-analysis

Tan,

et al. 2024

Ann Coloproctol

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“…Various medical societies recommend pharmacological VTE prophylaxis for up to 4 weeks for all postoperative cancer patients regardless of the type of surgery 5,13–15 . Recommendations regarding extended VTE prophylaxis after MIS for cancer are based on the results from the prospective observational study and the randomized controlled trial on the incidence of VTE after laparoscopic surgery for colorectal cancer that showed benefit of extended prophylaxis with LMWH 16,17 . The result was a nationwide shift toward 4‐week VTE prophylaxis with LMWH for all cancer patients undergoing MIS in Denmark, including our department as per September 2021.…”

Section: Discussionmentioning

confidence: 99%

Morbidity following robot‐assisted surgery in a gynecological oncology setting: A cohort study

Markauskas,

Blaakær,

Traen

et al. 2024

Acta Obstet Gynecol Scand

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IntroductionThe objective of the study was to provide a comprehensive description of perioperative morbidity associated with robot‐assisted surgery (RAS) in a gynecological oncology setting in order to improve the preoperative counseling of women and support shared decision‐making.Material and MethodsAll women scheduled for intended RAS between January 2015 and December 2022 were prospectively included in an electronic morbidity database for the analyses of perioperative complications.ResultsIn total, 2225 women were included. Sixty‐four patients (2.9%) experienced an intraoperative complication. Intraoperative complications were associated with a higher rate of conversion to laparotomy (15.6% vs. 1.8%, p < 0.001), a higher rate of major postoperative morbidity (9.3% vs. 2.4%, p < 0.001), and a higher rate of reoperation (9.3% vs. 1.7%, p < 0.001), compared to cases without intraoperative complications. Thirty‐day postoperative morbidity was evaluated according to the Memorial Sloan‐Kettering Cancer Center Surgical Secondary Events Grading System. Grade 3–5 events were considered major. A total of 57 patients (2.6%) experienced a major event after surgery, postoperative rupture of the vaginal vault being the most common complication requiring surgical intervention. Conversion to laparotomy occurred in 49 cases (2.2%) and was associated with higher intraoperative blood loss (300 mL vs. 25 mL, p < 0.001), a higher rate of postoperative major events (20.4% vs. 2.2%, p < 0.001), and a higher rate of reoperation (11.8% vs. 1.6%, p < 0.001).ConclusionsOur study demonstrates low rates of major perioperative morbidity and conversion to laparotomy after RAS performed by trained high‐volume surgeons in a gynecological oncology setting.

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“…One study found that the incidence of postoperative DVT based on routine compression ultrasound (US) at postoperative day 8 AE 2 in recipients of laparoscopic colorectal cancer surgery lasting more than 45 minutes was approximately 17%, despite pharmacological prophylaxis. 18…”

Section: Colorectal Surgerymentioning

confidence: 99%

Thromboprophylaxis in Cancer Patients Undergoing Surgery

Htun

Lee

2017

Semin Thromb Hemost

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Venous thromboembolism (VTE) is a common, complex, and costly complication in cancer patients undergoing surgery. VTE risk varies with types of cancer surgery as well as patient-, cancer-, and treatment-associated factors. Current VTE preventive measures with pharmacological, mechanical, and combination of both are shown to be effective. Clinical questions remain and more research is needed, focusing on the role of thromboprophylaxis for minimally invasive surgery and major cancer surgery other than abdominal/pelvic surgery, as well as optimal duration of thromboprophylaxis in high-risk patients. Routine individual VTE risk assessment and better adherence to thromboprophylaxis guidelines may offer improved outcomes in cancer patients undergoing surgery. A summary of currently available evidence and consensus guidelines on the primary prevention of VTE in cancer patients undergoing various types of surgery is presented here.

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Incidence and risk factors for venous thromboembolism after laparoscopic surgery for colorectal cancer

Cited by 27 publications

References 15 publications

Venous thromboembolism among Asian populations with localized colorectal cancer undergoing curative resection: is pharmacological thromboprophylaxis required? A systematic review and meta-analysis

Venous thromboembolism among Asian populations with localized colorectal cancer undergoing curative resection: is pharmacological thromboprophylaxis required? A systematic review and meta-analysis

Morbidity following robot‐assisted surgery in a gynecological oncology setting: A cohort study

Thromboprophylaxis in Cancer Patients Undergoing Surgery

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