Postoperative Venous Thromboembolism Rates Vary Significantly After Different Types of Major Abdominal Operations

Mukherjee, Debraj; Lidor, Anne O.; Chu, Kathryn; Gearhart, Susan L.; Haut, Elliott R.; Chang, David C.

doi:10.1007/s11605-008-0600-1

Cited by 101 publications

(58 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is possible that the increased risk associated with splenectomy was a postoperative phenomenon that might be seen with any major abdominal operation. Because the risk for postoperative thromboembolism has been shown to vary by type of operation, 31 the site of postoperative thrombosis (ie, abdominal vs peripheral) might also vary in the early vs later postoperative period. Because AbVTE is typically thought of as a surgical complication, it is not surprising that there was a fivefold higher risk of AbVTE in the early postoperative period that did not persist.…”

Section: Discussionmentioning

confidence: 99%

Splenectomy and the incidence of venous thromboembolism and sepsis in patients with immune thrombocytopenia

Boyle¹,

White

Brunson³

et al. 2013

Blood

183

148

View full text Add to dashboard Cite

• After splenectomy, patients with ITP have a higher risk of venous thrombosis and sepsis than patients with ITP who do not undergo splenectomy.Patients with immune thrombocytopenia (ITP) who relapse after an initial trial of corticosteroid treatment present a therapeutic challenge. Current guidelines recommend consideration of splenectomy, despite the known risks associated with surgery and the postsplenectomy state. To better define these risks, we identified a cohort of 9976 patients with ITP, 1762 of whom underwent splenectomy. The cumulative incidence of abdominal venous thromboembolism (AbVTE) was 1.6% compared with 1% in patients who did not undergo splenectomy; venous thromboembolism (VTE) (deep venous thrombosis and pulmonary embolus) after splenectomy was 4.3% compared with 1.7% in patients who did not undergo splenectomy. There was increased risk of AbVTE early (<90 days; hazard ratio [HR] 5.4 [confidence interval (CI), 2.3-12.5]), but not late ( ‡90 days; HR 1.5 [CI, 0.9-2.6]) after splenectomy. There was increased risk of VTE both early (HR 5.2 [CI, 3.2-8.5]) and late (HR 2.7 [CI, 1.9-3.8]) after splenectomy. The cumulative incidence of sepsis was 11.1% among the ITP patients who underwent splenectomy and 10.1% among the patients who did not. Splenectomy was associated with a higher adjusted risk of sepsis, both early (HR 3.3 [CI, 2.4-4.6]) and late (HR 1.6 or 3.1, depending on comorbidities). We conclude that ITP patients post splenectomy are at increased risk for AbVTE, VTE, and sepsis. (Blood. 2013;121(23):4782-4790)

show abstract

Section: Discussionmentioning

confidence: 99%

Splenectomy and the incidence of venous thromboembolism and sepsis in patients with immune thrombocytopenia

Boyle¹,

White

Brunson³

et al. 2013

Blood

183

148

View full text Add to dashboard Cite

show abstract

“…In addition, it is thought that mechanisms separate from reactive thrombocytosis after splenectomy may lead to a hypercoagulable state [39,40]. These findings may indicate the potential needs for anticoagulant therapy after surgery along with splenectomy [41,42] and preservation of the spleen is advantageous for reduction of thrombotic complications after surgery.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Hematological Changes after Spleen-Preserving Distal Pancreatectomy with Preservation of the Splenic Artery and Vein

Tezuka

Kimura²,

Hirai³

et al. 2012

Dig Surg

View full text Add to dashboard Cite

Background: The aim of this study was to determine the early postoperative hematological changes after spleen-preserving distal pancreatectomy (SpDP) with preservation of the splenic artery and vein (PSAV). Methods: We reviewed 53 patients who underwent SpDP with PSAV (n = 21) or distal pancreatectomy with splenectomy (DPS; n = 32) for benign or low-grade malignant lesions between July 1998 and June 2010. Red and white blood cell (WBC) count, platelet count, serum hemoglobin, hematocrit, C-reactive protein, albumin level, and clinical factors were compared between the SpDP with PSAV and DPS. Results: There were no significant differences in the patient characteristics between the two groups. Platelet count on postoperative day (POD) 5 and WBC count on POD 3 were significantly higher in the DPS group, and these differences continued to be significant until the 3rd month after surgery. Serum hemoglobin and hematocrit in the 1st month after surgery were also significantly higher in the SpDP with PSAV group. Conclusion: The hematological benefits of SpDP with PSAV include reduction of postoperative hematological abnormalities in the early postoperative phase and recovery of the serum hemoglobin and hematocrit levels in the early postoperative phase.

show abstract

“…This is despite the majority of them receiving chemoprophylaxis [14,15]. This risk level, and also the risk reported by Mukherjee et al [3] would justify our use of 2% with a 1% margin as a basis or our non-inferiority test. We have found in this test that our reported rates without chemoprophylaxis is not worse than that reported in the West in patients receiving chemoprophylaxis.…”

Section: Discussionmentioning

confidence: 68%

“…Mukherjee et al found that the incidence of VTE was 1.76% in patients undergoing hepatectomy and 2.91% in patients undergoing pancreatectomy respectively. Furthermore, the odds of developing VTE for these operations were found to be more than twice (OR 2.55 and 2.07 respectively) that of bariatric surgery patients [3]. Unfortunately, no data exists in literature on the incidence of VTE in HPB surgery patients in Asian patients.…”

Section: Discussionmentioning

confidence: 97%

“…The use of pharmacological prophylaxis after hepatic surgery is also debatable, with many surgeons taking a very cautious take on its use due to the possibility of postoperative coagulopathy [2]. On the other hand, a study looking at comparative rates of VTE incidence with different types of surgeries has suggested that HPB surgery is in fact associated with one of the highest rates of VTE [3]. Physiologically, this is unsurprising given the presence of malignancy, the relatively long duration of surgery and length of stay as well as the severity of the physiological insult.…”

mentioning

confidence: 99%

See 1 more Smart Citation

The incidence of clinically significant venous thromboembolism in an Asian population after major hepatobiliary and pancreatic surgery

Toh¹,

Pang²,

Woon³

et al. 2015

Int J Hepatobiliary Pancreat Dis

View full text Add to dashboard Cite

Postoperative Venous Thromboembolism Rates Vary Significantly After Different Types of Major Abdominal Operations

Cited by 101 publications

References 50 publications

Splenectomy and the incidence of venous thromboembolism and sepsis in patients with immune thrombocytopenia

Splenectomy and the incidence of venous thromboembolism and sepsis in patients with immune thrombocytopenia

Postoperative Hematological Changes after Spleen-Preserving Distal Pancreatectomy with Preservation of the Splenic Artery and Vein

The incidence of clinically significant venous thromboembolism in an Asian population after major hepatobiliary and pancreatic surgery

Contact Info

Product

Resources

About