Risk factors for postoperative proximal deep vein thrombosis and pulmonary embolism after laparoscopic colorectal cancer surgery: analysis of a multicenter randomized controlled trial

Surg Today. 2022 Jun;52(6):881-888. doi: 10.1007/s00595-021-02422-2. Epub 2021 Nov 29.

Abstract

Purpose: Postoperative venous thromboembolism (VTE) is a major and potentially fatal postoperative complication of colorectal cancer surgery. However, there is uncertainty about the necessity for anticoagulant prophylaxis to prevent VTE after laparoscopic colorectal cancer surgery because of its associated relatively lower incidence. Currently, anticoagulant therapy is considered mainly for patients at high risk of the development of VTE. Focusing on proximal deep vein thrombosis (DVT)/ pulmonary embolism (PE), we aimed to identify those cases at high risk of the development of fatal VTE.

Methods: We performed an exploratory retrospective analysis to identify the risk factors for postoperative proximal DVT and PE after laparoscopic colorectal cancer surgery in patients included in our prospective trial.

Results: A logistic regression analysis revealed factors that could predict the onset of proximal DVT/PE in patients with colorectal cancer. Blood loss and tumor location were identified as the predictors of proximal DVT/PE.

Conclusions: Patients with rectal cancer and those with excessive blood loss during colon cancer surgery must be monitored carefully for signs of VTE and especially proximal DVT/PE, after laparoscopic surgery.

Keywords: Colorectal cancer; Laparoscopic surgery; Prophylaxis; Venous thromboembolism.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Anticoagulants / therapeutic use
  • Colorectal Neoplasms* / complications
  • Humans
  • Laparoscopy* / adverse effects
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Prospective Studies
  • Pulmonary Embolism* / epidemiology
  • Pulmonary Embolism* / etiology
  • Pulmonary Embolism* / prevention & control
  • Retrospective Studies
  • Risk Factors
  • Venous Thromboembolism* / epidemiology
  • Venous Thrombosis* / epidemiology
  • Venous Thrombosis* / etiology
  • Venous Thrombosis* / prevention & control

Substances

  • Anticoagulants