Incidence of Venous Thromboembolism After Oral Oncologic Surgery With Simultaneous Reconstruction

Kakei, Yasumasa; Akashi, Mitsuru; Hasegawa, Takumi; Minamikawa, Tsutomu; Usami, Satoshi; Komori, Takahide

doi:10.1016/j.joms.2015.08.006

Cited by 36 publications

(41 citation statements)

References 17 publications

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“…Lastly, most reported studies included patients who underwent treatment for their malignancies, and many of these treatments are also known to be independent risk factors of venous thromboembolism. These factors include surgical treatment, a favored treatment for H&N cancer that is often involves long procedures, especially in cases of simultaneous reconstruction [47,57,58]. These factors also include chemotherapy, which has been clearly identified as an independent risk factor for venous thromboembolism [59,60].…”

Section: The Lack Of Clinical Evidencementioning

confidence: 99%

Thrombosis Risk Associated with Head and Neck Cancer: A Review

Haen

Mège

Crescence

et al. 2019

IJMS

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Venous thromboembolism (VTE) is a common complication for cancer patients. VTE-associated risk varies according to the type of tumor disease. Head and neck cancer is a common cancer worldwide, and most tumors are squamous cell carcinomas due to tobacco and alcohol abuse. The risk of VTE associated with head and neck (H&N) cancer is considered empirically low, but despite the high incidence of H&N cancer, few data are available on this cancer; thus, it is difficult to state the risk of VTE. Our review aims to clarify this situation and tries to assess the real VTE risk associated with H&N cancer. We report that most clinical studies have concluded that there is a very low thrombosis risk associated with H&N cancer. Even with the biases that often exist, this clinical review seems to confirm that the risk of VTE was empirically hypothesized. Furthermore, we highlight that H&N cancer has all the biological features of a cancer associated with a high thrombosis risk, including a strong expression of procoagulant proteins, modified thrombosis/fibrinolysis mechanisms, and secretions of procoagulant microparticles and procoagulant cytokines. Thus, this is a paradoxical situation, and some undiscovered mechanisms that could explain this clinical biological ambivalence might exist.

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Section: The Lack Of Clinical Evidencementioning

confidence: 99%

Thrombosis Risk Associated with Head and Neck Cancer: A Review

Haen

Mège

Crescence

et al. 2019

IJMS

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“…81 On the other hand, the greatest incidence of DVT has been shown to occur in patients undergoing comprehensive resection with reconstruction. 3,5,7 One study demonstrated a fourfold increase in DVT in patients undergoing head and neck reconstruction. 4 The role of chemoprophylaxis with anticoagulants in patients undergoing microvascular reconstruction is particularly challenging, given the potential failure of microvascular reconstruction from bleeding or hematoma.…”

Section: Discussionmentioning

confidence: 99%

“…Several authors recommend mobilizing the patient as early as the second postoperative day. 3,7,8 No studies, however, have shown that time to ambulation predicts the presence of DVT. 5,9…”

Section: Mechanical Methodsmentioning

confidence: 99%

Thromboprophylaxis in Head and Neck Microvascular Reconstruction

Abraham

Badhey

et al. 2018

Craniomaxillofacial Trauma & Reconstruction

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Head and neck patients undergoing microvascular reconstruction are at high risk for thromboembolism. While the prevention of thromboembolism has become an essential aspect of care, within the field of microsurgery, concern for anastomotic complications have hindered the creation of an accepted regimen. The aim of this review was to evaluate the risks and benefits of prophylactic agents for thromboprophylaxis. A literature search was conducted in MEDLINE, Cochrane Library, and PubMed/NCBI databases. Articles discussing thromboprophylaxis in otolaryngology, head and neck surgery, or microvascular reconstruction were considered in the review from the past 30 years. The majority of patients undergoing microvascular surgery have multiple risk factors for thrombus formation. Several consensus guidelines exist for the prophylaxis in patients who are critically ill, undergoing surgery, or with malignancy. Significant evidence supports the routine use of mechanical means, such as early mobilization and pneumatic compression along with subcutaneous heparin. Low-molecular-weight heparin is also frequently utilized, although results are largely divided. Data on aspirin remain equivocal. Studies on microvascular failure and flap loss have demonstrated little to no association with chemoprophylaxis. The evidence for postoperative thromboprophylaxis regimens in patients undergoing head and neck free tissue transfer is variable. Multiple studies have supported the use of unfractionated heparin or low-molecular-weight heparin. There appears to be an expert consensus for the combined use of mechanical prophylactic methods and chemical prophylaxis. Prospective randomized trials are required to validate the most effective combination of chemoprophylaxis agents.

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“…Reports of VTE occurrences are followed by other cancer surgery procedures of the head and neck, which include oral and maxillofacial surgery procedures or also commonly performed breast cancer surgery [55][56][57][58][59][60]. According to Tran et al the risk of overt VTE in a population of 49 028 patients undergoing mastectomy amounted to 0.23% [58].…”

Section: Chapter 2 the Prevention Of Venous Thromboembolism In Cancementioning

confidence: 99%