TY - JOUR
T1 - Impact of routine preoperative sonographic screening with early intervention for deep venous thrombosis in lower extremities on preventing postoperative venous thromboembolism in patients with gastric cancer scheduled for minimally invasive surgery
AU - Suzuki, Kazumitsu
AU - Shibasaki, Susumu
AU - Nakauchi, Masaya
AU - Nakamura, Kenichi
AU - Akimoto, Shingo
AU - Tanaka, Tsuyoshi
AU - Kikuchi, Kenji
AU - Inaba, Kazuki
AU - Uyama, Ichiro
AU - Suda, Koichi
N1 - Funding Information:
Kazumitsu Suzuki, Susumu Shibasaki, Masaya Nakauchi, Kenichi Nakamura, Shingo Akimoto, Tsuyoshi Tanaka, Kenji Kikuchi, Kazuki Inaba, Koichi Suda, and Ichiro Uyama have no commercial association with or financial involvement that might pose a conflict of interest in connection with the submitted article. Ichiro Uyama has received lecture fees from Intuitive Surgical, Inc., outside of the submitted work. Koichi Suda, Tsuyoshi Tanaka, and Kenji Kikuchi have been funded by Medicaroid, Inc. in relation to the Collaborative Laboratory for Research and Development in Advanced Surgical Technology, Fujita Health University. Koichi Suda has also received advisory fees from Medicaroid, Inc., outside of the submitted work.
Funding Information:
The authors would like to thank MARUZEN-YUSHODO Co., Ltd. (https://kw.maruzen.co.jp/kousei-honyaku/) for the English language editing.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2022/3
Y1 - 2022/3
N2 - Purpose: This study aimed to investigate the clinical efficacy of lower-extremity ultrasonography screening with early intervention for deep venous thrombosis (DVT) on the incidence of venous thromboembolism (VTE) after minimally invasive surgery (MIS) for gastric cancer (GC). Methods: Between January 2012 and December 2019, 1070 patients were diagnosed with both clinical and pathological stage I–III GC and underwent MIS at our institution. Routine ultrasonographic screening for DVT in lower extremities is performed before MIS. Patients diagnosed with DVT were preoperatively administered anticoagulant therapy. Enoxaparin was routinely administrated after surgery irrespective of the presence of DVT. The incidence of postoperative symptomatic VTE was examined retrospectively. Results: A total of 74 (6.9%) patients were preoperatively diagnosed with DVT. Multivariate analyses revealed that age > 70 years (p = 0.015), female sex (p < 0.001), and positive serum D-dimer test (p < 0.001) were significant and independent risk factors for preoperative DVT. The incidence of symptomatic postoperative VTE was 1 (0.09%); symptomatic VTE developed in one patient among patients without DVT, whereas no patient with DVT developed VTE. Conclusions: Preoperative DVT screening using lower-extremity ultrasonography followed by preoperative anticoagulant therapy should be considered as a useful strategy to safely perform MIS for GC without increasing the incidence of VTE.
AB - Purpose: This study aimed to investigate the clinical efficacy of lower-extremity ultrasonography screening with early intervention for deep venous thrombosis (DVT) on the incidence of venous thromboembolism (VTE) after minimally invasive surgery (MIS) for gastric cancer (GC). Methods: Between January 2012 and December 2019, 1070 patients were diagnosed with both clinical and pathological stage I–III GC and underwent MIS at our institution. Routine ultrasonographic screening for DVT in lower extremities is performed before MIS. Patients diagnosed with DVT were preoperatively administered anticoagulant therapy. Enoxaparin was routinely administrated after surgery irrespective of the presence of DVT. The incidence of postoperative symptomatic VTE was examined retrospectively. Results: A total of 74 (6.9%) patients were preoperatively diagnosed with DVT. Multivariate analyses revealed that age > 70 years (p = 0.015), female sex (p < 0.001), and positive serum D-dimer test (p < 0.001) were significant and independent risk factors for preoperative DVT. The incidence of symptomatic postoperative VTE was 1 (0.09%); symptomatic VTE developed in one patient among patients without DVT, whereas no patient with DVT developed VTE. Conclusions: Preoperative DVT screening using lower-extremity ultrasonography followed by preoperative anticoagulant therapy should be considered as a useful strategy to safely perform MIS for GC without increasing the incidence of VTE.
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U2 - 10.1007/s00423-021-02315-5
DO - 10.1007/s00423-021-02315-5
M3 - Article
C2 - 34471954
AN - SCOPUS:85114033196
VL - 407
SP - 597
EP - 608
JO - Langenbeck's Archives of Surgery
JF - Langenbeck's Archives of Surgery
SN - 1435-2443
IS - 2
ER -