Perception of Chemical Venous Thromboprophylaxis for Oncologic Lung Resections among Thoracic Surgeons

Malgor, Rafael D.; Bilfinger, Thomas V.; Blebea, John; Ma, Harry; Arnold, Shirliejean R.

doi:10.1016/j.avsg.2017.03.188

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…The majority of surgeons in the USA do provide pharmacological thromboprophylaxis to patients who undergo lung resection but they do not provide extended VTE prophylaxis post discharge. Most of the surgeons believe that VTE prophylaxis is safe and not related to any additional postoperative bleeding events (36). It is widely felt that the prevention of severe and potentially fatal PE outweighs the risks of postoperative bleeding.…”

Section: Perioperative Preventionmentioning

confidence: 99%

Deep vein thrombosis and pulmonary embolism following lung resection

Kolokotroni¹

2021

Shanghai Chest

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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.

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Section: Perioperative Preventionmentioning

confidence: 99%