Shu L, Xia CW, Pang YF. Prevention and management of postoperative deep vein thrombosis in lower extremities of patients with gastrointestinal tumor. World J Gastrointest Surg 2024; 16(10): 3269-3276 [PMID: 39575268 DOI: 10.4240/wjgs.v16.i10.3269]
Corresponding Author of This Article
Liang Shu, MBBS, Attending Doctor, Department of Thyroid Surgery, Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou 646000, Sichuan Province, China. 17620186230@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Prospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Oct 27, 2024; 16(10): 3269-3276 Published online Oct 27, 2024. doi: 10.4240/wjgs.v16.i10.3269
Prevention and management of postoperative deep vein thrombosis in lower extremities of patients with gastrointestinal tumor
Liang Shu, Cheng-Wei Xia, Yu-Fan Pang
Liang Shu, Cheng-Wei Xia, Yu-Fan Pang, Department of Thyroid Surgery, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Author contributions: The concept of this study was jointly proposed by Shu L and Xia CW, who participated in data collection; the initial draft was drafted by Shu L; Pang YF contributed to the formal analysis of this study; Shu L guided the research, methodology, and visualization of the manuscript; Shu L, Pang YF and Xia CW participated in this study, validated it; all authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Affiliated Hospital of Southwest Medical University Institutional Review Board, No. XNYK-2022-132.
Clinical trial registration statement: This study is registered at the Clinical Registry: https://www.researchregistry.com (Researchregistry10638).
Informed consent statement: The study has obtained the consent of patients and guardians, and an informed consent form has been signed.
Conflict-of-interest statement: Dr. Shu has nothing to disclose.
Data sharing statement: The original contributions presented in the study are included in the article. Further inquiries can be directed to the corresponding authors.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Liang Shu, MBBS, Attending Doctor, Department of Thyroid Surgery, Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou 646000, Sichuan Province, China. 17620186230@163.com
Received: August 8, 2024 Revised: September 4, 2024 Accepted: September 6, 2024 Published online: October 27, 2024 Processing time: 50 Days and 20.3 Hours
Abstract
BACKGROUND
Deep vein thrombosis (DVT) is a significant postoperative concern, particularly in patients undergoing surgery for gastrointestinal (GI) cancers. These patients often present multiple risk factors, including advanced age and elevated body mass index (BMI), which can increase the likelihood of thromboembolic events. Effective prophylaxis is crucial in this high-risk population to minimize complications such as DVT and pulmonary embolism (PE). This study investigates a comprehensive DVT prevention protocol, combining mechanical and pharmacological strategies alongside early mobilization, to evaluate its effectiveness and safety in reducing postoperative thrombosis rates among GI cancer surgery patients.
AIM
To evaluate the effectiveness and safety of postoperative DVT prevention strategies in patients with GI cancer.
METHODS
A prospective cohort study was conducted involving 100 patients who underwent surgery for GI tumors between January and December 2022. All patients received a standardized DVT prevention protocol, which included risk assessment, mechanical prophylaxis, pharmacological prophylaxis, and early mobilization. The primary endpoint was the incidence of DVT within 30 days postoperatively. Secondary outcomes included the occurrence of PE, bleeding complications, and adherence to the protocol.
RESULTS
The overall incidence of DVT was 7% (7/100 patients). One patient (1%) developed PE. The adherence rate to the prevention protocol was 92%. Bleeding complications were observed in 3% of patients. Significant risk factors for DVT development included advanced age [odds ratio (OR): 1.05; 95% confidence interval (95%CI): 1.01-1.09], higher BMI (OR: 1.11; 95%CI: 1.03-1.19), and longer operative time (OR: 1.007; 95%CI: 1.001-1.013).
CONCLUSION
Implementing a comprehensive DVT prevention and management protocol for patients undergoing GI tumor surgery resulted in a lower incidence. Strict adherence and individualized risk assessment are crucial for optimizing outcomes.
Core Tip: This study evaluates the effectiveness of a comprehensive deep vein thrombosis (DVT) prevention and management protocol in patients undergoing gastrointestinal (GI) cancer surgery. The protocol encompasses risk assessment, mechanical and pharmacological prophylaxis, early mobilization, and patient education. The findings reveal a 7% DVT incidence rate, with significant risk factors including advanced age, elevated body mass index, and extended surgery duration. The protocol demonstrated high adherence and low complication rates, highlighting its efficacy in reducing postoperative DVT in patients with high-risk GI cancer.
