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» Articles » PMID: 38214871

Risk Factors for Venous Thrombosis After Esophagectomy

Overview
Journal Esophagus
Publisher Springer
Specialties Gastroenterology
Oncology
Date 2024 Jan 12
PMID 38214871
Authors
Naoya Torii
Kazushi Miyata
Masahide Fukaya
Tomoki Ebata
Affiliations
Soon will be listed here.
Abstract

Background: Venous thrombosis (VT) after esophagectomy for esophageal cancer is an important complication, potentially leading to pulmonary embolism. However, there are few available information about the risk for the postsurgical VT.

Methods: This study included 271 patients who underwent esophagectomy for esophageal cancer between 2006 and 2019. Contrast-enhanced computed tomography (CT) was performed for all patients on the seventh postoperative day to survey complications, including VT.

Results: VT was radiologically visualized in 48 patients (17.7%), 8 of whom (16.7%) had pulmonary embolism. The thrombus disappeared in 42 patients, the thrombus size was unchanged in 5 patients, and 1 patient died. Multivariate analysis was performed on factors clinically considered to have a significant influence on thrombus formation. The analysis showed that CVC insertion via the femoral vein (odds ratio, 7.67; 95% CI, 2.64-22.27; P < 0.001), retrosternal reconstruction route (odds ratio, 3.94; 95% CI, 1.90-8.17; P < 0.001) and intraoperative fluid balance < 5 ml/kg/hr (odds ratio, 0.38; 95% CI, 0.17-0.85; P = 0.019) were independently related to VT.

Conclusions: Intraoperative fluid balance < 5 ml/kg/hr, along with CVC insertion via the femoral vein and retrosternal reconstruction may be potential risk factors for VT after esophagectomy.

References
1.
Ohkura Y, Miyata H, Konno H, Udagawa H, Ueno M, Shindoh J . Development of a model predicting the risk of eight major postoperative complications after esophagectomy based on 10 826 cases in the Japan National Clinical Database. J Surg Oncol. 2019; 121(2):313-321. DOI: 10.1002/jso.25800. View
2.
Martin J, Mahan A, Ferraris V, Saha S, Mullett T, Zwischenberger J . Identifying Esophagectomy Patients at Risk for Predischarge Versus Postdischarge Venous Thromboembolism. Ann Thorac Surg. 2015; 100(3):932-8. DOI: 10.1016/j.athoracsur.2015.04.042. View
3.
Bellini G, Teng A, Kotecha N, Sutton E, Yang C, Passeri M . The identification of risk factors for venous thromboembolism in gastrointestinal oncologic surgery. J Surg Res. 2016; 205(2):279-285. DOI: 10.1016/j.jss.2016.06.089. View
4.
Hammond J, Kozma C, Hart J, Nigam S, Daskiran M, Paris A . Rates of venous thromboembolism among patients with major surgery for cancer. Ann Surg Oncol. 2011; 18(12):3240-7. DOI: 10.1245/s10434-011-1723-2. View
5.
Ando N, Kato H, Igaki H, Shinoda M, Ozawa S, Shimizu H . A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907). Ann Surg Oncol. 2011; 19(1):68-74. DOI: 10.1245/s10434-011-2049-9. View