The Importance of Extended Postoperative Venous Thromboembolism Prophylaxis in IBD

Gross, Molly E.; Vogler, Sarah A.; Mone, Mary C.; Sheng, Xiaoming; Sklow, Bradford

doi:10.1097/dcr.0000000000000090

Cited by 72 publications

(52 citation statements)

References 9 publications

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“…right hemicolectomy, total proctocolectomy (TPC), sigmoidectomy]. Two studies compared the types of operation being performed for IBD and CRC patients . There was no significant difference between laparoscopic and open approaches or for pelvic and abdominal operations between the two groups.…”

Section: Resultsmentioning

confidence: 99%

Extended thromboprophylaxis following colorectal surgery in patients with inflammatory bowel disease: a comprehensive systematic clinical review

et al. 2019

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Aim Patients with inflammatory bowel disease (IBD) are at increased risk of postoperative venous thromboembolism (VTE) following major abdominal surgery. The pathogenesis is multifactorial and not fully understood. A combination of pathophysiology, patient and surgical risk factors increase the risk of postoperative VTE in these patients. Despite being at increased risk, IBD patients are not regularly prescribed extended pharmacological thromboprophylaxis following colorectal surgery. Currently, there is a paucity of evidence‐based guidelines. Thus, the aim of this review is to evaluate the role of extended pharmacological thromboprophylaxis in IBD patients undergoing colorectal surgery. Method A search of Ovid Medline, EMBASE and PubMed databases was performed. A qualitative analysis was performed using 10 clinical questions developed by colorectal surgeons and a thrombosis haematologist. The Newcastle–Ottawa Scale was utilized to assess the quality of evidence. Results A total of 1229 studies were identified, 38 of which met the final inclusion criteria (37 retrospective, one case–control). Rates of postoperative VTE ranged between 0.6% and 8.9%. Patient‐specific risk factors for postoperative VTE included ulcerative colitis, increased age and obesity. Surgery‐specific risk factors for postoperative VTE included open surgery, emergent surgery and ileostomy creation. Patients with IBD were more frequently at increased risk in the included studies for postoperative VTE than patients with colorectal cancer. The risk of bias assessment demonstrated low risk of bias in patient selection and comparability, with variable risk of bias in reported outcomes. Conclusion There is a lack of evidence regarding the use of extended pharmacological thromboprophylaxis in patients with IBD following colorectal surgery. As these patients are at heightened risk of postoperative VTE, future study and consideration of the use of extended pharmacological thromboprophylaxis is warranted.

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Section: Resultsmentioning

confidence: 99%

Extended thromboprophylaxis following colorectal surgery in patients with inflammatory bowel disease: a comprehensive systematic clinical review

et al. 2019

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“…Several authors have noted the high rates of postoperative venous thromboembolism in IBD patients and have suggested the extended use of venous thromboembolism prophylaxis [64][65][66]69] along the same lines as in current standard practice for patients undergoing colorectal cancer resection.…”

Section: Risk Of Venous Thromboembolism In Patients Requiring Surgerymentioning

confidence: 99%

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in surgery for inflammatory bowel disease

et al. 2018

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Aim There is a requirement of an expansive and up to date review of surgical management of inflammatory bowel disease (IBD) that can dovetail with the medical guidelines produced by the British Society of Gastroenterology. Methods Surgeons who are members of the ACPGBI with a recognised interest in IBD were invited to contribute various sections of the guidelines. They were directed to produce a procedure based document using literature searches that were systematic, comprehensible, transparent and reproducible. Levels of evidence were graded. An editorial board was convened to ensure consistency of style, presentation and quality. Each author was asked to provide a set of recommendations which were evidence based and unambiguous. These recommendations were submitted to the whole guideline group and scored. They were then refined and submitted to a second vote. Only those that achieved >80% consensus at level 5 (strongly agree) or level 4 (agree) after 2 votes were included in the guidelines. Results All aspects of surgical care for IBD have been included along with 157 recommendations for management. Conclusion These guidelines provide an up to date and evidence based summary of the current surgical knowledge in the management of IBD and will serve as a useful practical text for clinicians performing this type of surgery.

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“…Hospitalization was associated with higher costs ($47515 vs $21499, P < 0.0001) and higher mortality (adjusted OR = 2.5, 95%CI: 1.83-3.43) in IBD patients compared with controls[85]. IBD patients undergoing surgery have an increased risk for postoperative VTE (OR = 1.26, 95%CI: 1.021-1.56, P = 0.03) compared with patients undergoing surgery for colorectal cancer[86]. Therefore, it has been suggested that VTE prophylaxis in postoperative IBD patients be extended out-of-hospital for 4 wk after discharge[87,88].…”

Section: Prevention Of Venous Thromboembolismmentioning

confidence: 99%

Preventive health measures in inflammatory bowel disease

Abegunde

Muhammad

Ali

2016

WJG

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We aim to review the literature and provide guidance on preventive health measures in inflammatory bowel disease (IBD). Structured searches were performed in PubMed, MEDLINE, EMBASE, Web of Science and Cochrane Library from January 1976 to June 2016 using the following keywords: (inflammatory bowel disease OR Crohn’s disease OR ulcerative colitis) AND (health maintenance OR preventive health OR health promotion). Abstracts of the articles selected from each of these multiple searches were reviewed, and those meeting the inclusion criteria (that is, providing data regarding preventive health or health maintenance in IBD patients) were recorded. Reference lists from the selected articles were manually reviewed to identify further relevant studies. Patients with IBD are at increased risk of developing adverse events related to the disease course, therapeutic interventions, or non-adherence to medication. Recent studies have suggested that IBD patients do not receive preventive services with the same thoroughness as patients with other chronic diseases. Preventive health measures can avert morbidity and improve the quality of life of patients with IBD. Gastroenterologists and primary care physicians (PCPs) should have an up to date working knowledge of preventive health measures for IBD patients. A holistic approach and better communication between gastroenterologists and PCPs with explicit clarification of roles will prevent duplication of services and streamline care.

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The Importance of Extended Postoperative Venous Thromboembolism Prophylaxis in IBD

Cited by 72 publications

References 9 publications

Extended thromboprophylaxis following colorectal surgery in patients with inflammatory bowel disease: a comprehensive systematic clinical review

Extended thromboprophylaxis following colorectal surgery in patients with inflammatory bowel disease: a comprehensive systematic clinical review

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in surgery for inflammatory bowel disease

Preventive health measures in inflammatory bowel disease

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