Extended postoperative thromboprophylaxis after pancreatic resection for pancreatic cancer is associated with decreased risk of venous thromboembolism in the minimally invasive approach.

Autor: Sood D; Department of Surgery, University of Chicago, Chicago, Illinois, USA., Kuchta K; Department of Surgery, NorthShore University HealthSystem, Evanston, Illinois, USA., Paterakos P; Department of Surgery, NorthShore University HealthSystem, Evanston, Illinois, USA., Schwarz JL; Department of Surgery, University of Chicago, Chicago, Illinois, USA., Rojas A; Department of Surgery, NorthShore University HealthSystem, Evanston, Illinois, USA., Choi SH; Department of Surgery, NorthShore University HealthSystem, Evanston, Illinois, USA., Vining CC; Department of Surgery, The Pennsylvania State University, Hershey, Pennsylvania, USA., Talamonti MS; Department of Surgery, NorthShore University HealthSystem, Evanston, Illinois, USA., Hogg ME; Department of Surgery, NorthShore University HealthSystem, Evanston, Illinois, USA.
Jazyk: angličtina
Zdroj: Journal of surgical oncology [J Surg Oncol] 2023 Mar; Vol. 127 (3), pp. 413-425. Date of Electronic Publication: 2022 Nov 11.
DOI: 10.1002/jso.27135
Abstrakt: Background: Pancreatic ductal adenocarcinoma (PDAC) is associated with increased venous thromboembolism (VTE). We sought to compare rates of bleeding complications and VTE in patients receiving extended postoperative thromboprophylaxis (EPT) to those who did not, and identify risk factors for VTE after pancreatectomy for PDAC.
Methods: This is a retrospective review of pancreatectomies for PDAC. EPT was defined as 28 days of low molecular weight heparin. Multivariable analysis (MVA) was performed to identify independent risk factors of VTE.
Results: Of 269 patients included, 142 (52.8%) received EPT. Of those who received EPT, 7 (4.9%) suffered bleeding complications, compared to 6 (4.7%) of those who did not (p = 0.938). There was no significant difference in VTE rate at 90 days (2.8% vs. 2.4%, p = 0.728) or at 1 year (6.3% vs. 7.9%, p = 0.624). On MVA, risk factors for VTE included worse performance status, lower preoperative hematocrit, R1/R2 resection, and minimally invasive (MIS) approach. Among those who received EPT, there was no difference in VTE rate between MIS and open approach.
Conclusions: EPT was not associated with a difference in VTE risk or bleeding complications. MIS approach was associated with a higher risk of VTE; however, this was significantly lower among those who received EPT.
(© 2022 Wiley Periodicals LLC.)
Databáze: MEDLINE
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