Venous thromboembolism in colorectal surgery: Incidence, risk factors, and prophylaxis

被引：30

作者：

Emoto, Shigenobu ^{[1
]}

Nozawa, Hiroaki ^{[1
]}

Kawai, Kazushige ^{[1
]}

Hata, Keisuke ^{[1
]}

Tanaka, Toshiaki ^{[1
]}

Shuno, Yasutaka ^{[1
]}

Nishikawa, Takeshi ^{[1
]}

Sasaki, Kazuhito ^{[1
]}

Kaneko, Manabu ^{[1
]}

Hiyoshi, Masaya ^{[1
]}

Murono, Koji ^{[1
]}

Ishihara, Soichiro ^{[1
]}

机构：

[1] Univ Tokyo, Dept Surg Oncol, Tokyo, Japan

来源：

ASIAN JOURNAL OF SURGERY | 2019年 / 42卷 / 09期

基金：

日本学术振兴会;

关键词：

Colorectal cancer; Inflammatory bowel disease; Laparoscopic surgery; Venous thromboembolism; DEEP-VEIN THROMBOSIS; INFLAMMATORY-BOWEL-DISEASE; MOLECULAR-WEIGHT HEPARIN; INTERMITTENT PNEUMATIC COMPRESSION; CANCER-SURGERY; LAPAROSCOPIC SURGERY; PULMONARY-EMBOLISM; EXTENDED THROMBOPROPHYLAXIS; PRACTICE GUIDELINES; HOSPITAL DISCHARGE;

D O I：

10.1016/j.asjsur.2018.12.013

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Colorectal surgery is associated with a high risk of perioperative venous thromboembolism (VTE), and this risk is especially high following colorectal cancer resection and surgery for inflammatory bowel disease. Previous analyses of large databases have reported the incidence of postoperative VTE in this population to be approximately 1.1%-2.5%. Therefore, to minimize this risk, patients should be offered appropriate prophylaxis, which may involve a combination of mechanical and pharmacologic prophylaxis with low-dose unfractionated heparin or low molecular weight heparin as recommended by several guidelines. Prior to initiation of treatment, appropriate risk stratification should be performed according to the patients' basic and disease-related as well as procedure-related risk factors, and post-operative factors. Furthermore, a risk-benefit calculation that takes into account patients' VTE and bleeding risk should be performed prior to starting pharmacologic prophylaxis and to help determine the duration of treatment. (C) 2019 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V.

引用

页码：863 / 873

页数：11

共 90 条

[1] Randomized clinical trial of postoperative fondaparinux versus perioperative dalteparin for prevention of venous thromboembolism in high-risk abdominal surgery [J].