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

• DOI: 10.1007/s00423-021-02315-5
• Publication Date: 2021-09-01T21:02:22Z
• Authors: Kazumitsu Suzuki; Susumu Shibasaki; Masaya Nakauchi; Kenichi Nakamura; Shingo Akimoto; Tsuyoshi Tanaka; Kenji Kikuchi; Kazuki Inaba; Ichiro Uyama; Koichi Suda
• Keywords: Male; Venous Thrombosis; Incidence; Venous Thromboembolism; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Lower Extremity; Risk Factors; Stomach Neoplasms; Humans; Minimally Invasive Surgical Procedures; Female; Pulmonary Embolism; Early Detection of Cancer; Aged; Retrospective Studies; Ultrasonography

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).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.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.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.