Jiang Y, Wang JF. Perioperative anticoagulation reduces the incidence of venous thromboembolism in patients undergoing gastrointestinal surgery. World J Gastrointest Surg 2025; 17(8): 107967 [DOI: 10.4240/wjgs.v17.i8.107967]
Corresponding Author of This Article
Jia-Fei Wang, Department of Gastrointestinal Surgery, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, No. 261 Huansha Road, Hangzhou 310000, Zhejiang Province, China. docjf_wang@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective 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. Aug 27, 2025; 17(8): 107967 Published online Aug 27, 2025. doi: 10.4240/wjgs.v17.i8.107967
Perioperative anticoagulation reduces the incidence of venous thromboembolism in patients undergoing gastrointestinal surgery
Ying Jiang, Jia-Fei Wang
Ying Jiang, Jia-Fei Wang, Department of Gastrointestinal Surgery, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou 310000, Zhejiang Province, China
Author contributions: Jiang Y participated in the protocol design, data interpretation, data management, and manuscript drafting; Wang JF revised the manuscript, had full access to all of the data analyzed in the study, and was ultimately responsibility for the decision to submit for the article for publication; and all authors thoroughly reviewed and endorsed the final manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, No. K2024-IRB-059.
Informed consent statement: Due to the retrospective nature of this study, the ethics committee approved a waiver of informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: There are no privacy concerns regarding the data analyzed this study, which can be obtained from the corresponding author upon request.
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: Jia-Fei Wang, Department of Gastrointestinal Surgery, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, No. 261 Huansha Road, Hangzhou 310000, Zhejiang Province, China. docjf_wang@163.com
Received: April 30, 2025 Revised: May 26, 2025 Accepted: July 9, 2025 Published online: August 27, 2025 Processing time: 116 Days and 23.7 Hours
Abstract
BACKGROUND
The risk and mortality rate of venous thromboembolism (VTE) following gastrointestinal surgery remain high, and the symptoms are atypical. Therefore, it is necessary to identify the risk factors associated with the occurrence of VTE following gastrointestinal surgery and to implement appropriate prevention and treatment measures.
AIM
To assess the efficacy of perioperative anticoagulation for the prevention of postoperative VTE.
METHODS
This retrospective study enrolled 205 patients who underwent gastrointestinal surgery. In the observation group (n = 101), prophylactic anticoagulation was administered via hypodermic injection of low-molecular-weight heparin during the perioperative period, whereas the control group (n = 104) only received low-molecular-weight heparin treatment postoperatively. Blood coagulation parameters and the incidence of VTE of the bilateral lower limbs pre- and post-surgery were compared between groups. Postoperative VTE was transformed into a dichotomous variable, and influencing factors were explored using multivariate logistic regression analyses.
RESULTS
On the 7th day postoperatively, the incidence of VTE of the bilateral lower limbs was significantly lower in the observation group than in the control group, as were the D-dimer levels (P < 0.05). At 1 month postoperatively, the incidence of VTE was significantly lower in the observation group than in the control group (P < 0.05). An age ≥ 65 years, a body mass index ≥ 24 kg/m2, and malignant diseases of the digestive system were identified as risk factors for the occurrence of postoperative VTE in patients undergoing gastrointestinal surgery.
CONCLUSION
The incidence of VTE in patients who underwent gastrointestinal surgery peaked within 1 week postoperatively. The findings confirmed perioperative anticoagulation can safely and effectively reduce the incidence of postoperative VTE.
Core Tip: This retrospective study single-center observational study compared the outcomes of perioperative and postoperative venous thromboembolism (VTE) and investigated the risk factors in patients who underwent gastrointestinal surgery. The incidence of VTE peaked within 1 week post-surgery, and prophylactic anticoagulation therapy with low molecular weight heparin reduced the incidence of VTE and exhibited a good safety profile. An age ≥ 65 years, a body mass index ≥ 24 kg/m2, and malignant diseases of the digestive system were identified as risk factors for the occurrence of postoperative VTE in patients undergoing gastrointestinal surgery.
