Prevention and management of postoperative deep vein thrombosis in lower extremities of patients with gastrointestinal tumor

Liang Shu; Cheng-Wei Xia; Yu-Fan Pang

doi:10.4240/wjgs.v16.i10.3269

Prevention and management of postoperative deep vein thrombosis in lower extremities of patients with gastrointestinal tumor

World J Gastrointest Surg. 2024 Oct 27;16(10):3269-3276. doi: 10.4240/wjgs.v16.i10.3269.

Authors

Liang Shu¹, Cheng-Wei Xia², Yu-Fan Pang²

Affiliations

¹ Department of Thyroid Surgery, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China. 17620186230@163.com.
² Department of Thyroid Surgery, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China.

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.

Keywords: Deep vein thrombosis; Gastrointestinal tumors; Postoperative complications; Thromboprophylaxis; Venous thromboembolism.