The prevalence of venous thromboembolism in rectal surgery: a systematic review and meta-analysis

Hayes, Joshua; Ryan, Éanna J; Boland, Patrick A; Creavin, Ben; Kelly, Michael E.; Beddy, David

doi:10.1007/s00384-019-03244-y

Cited by 10 publications

(6 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several meta-analyses have reported that the VTE incidence ranged from 1.25% to 15.7% in patients without COVID-19 undergoing surgery for benign lesions or tumors. [48][49][50] The overall VTE incidence was 28.3% among the hospitalized COVID-19 patients. Therefore, COVID-19 pneumonia might be an additional risk factor for VTE and should be prevented if possible and treated promptly.…”

Section: Discussionmentioning

confidence: 99%

A systematic review and meta-analysis of incidence, prognosis, and laboratory indicators of venous thromboembolism in hospitalized patients with coronavirus disease 2019

Liu

Cai

Wang

et al. 2021

Journal of Vascular Surgery: Venous and Lymphatic Disorders

View full text Add to dashboard Cite

Objective: We have summarized the incidence, anticoagulation panels, laboratory characteristics, and mortality of venous thromboembolism (VTE) in hospitalized patients with coronavirus disease 2019 .Methods: After systematically searching PubMed, Embase, the Cochrane Library, MedRxiv, and BioRxiv, a systematic review and meta-analysis of 18 retrospective, 6 prospective observational, and 2 cross-sectional studies was performed according to the guidelines of the PRISMA (preferred reporting items for systematic reviews and meta-analyses) statement.Results: Overall, 4382 hospitalized patients with COVID-19 were included. Men accounted for significantly more patients than did women (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.25-2.02; P < .001). The total incidence of VTE among the patients with COVID-19 was 28.3% (95% CI, 21.6%-35.4%), with an incidence of 38.0% (95% CI, 29.1%-47.4%) and 17.2% (95% CI, 11.4%-23.8%) among those with severe and general COVID-19, respectively. The total incidence of deep vein thrombosis (DVT) of the lower extremities was 18.3% (95% CI, 10.8%-27.2%). The incidence of DVT was 22.1% (95% CI, 11.0%-35.5%) and 12.8% (95% CI, 5.0%-23.3%) in those with severe and general COVID-19, respectively. The total incidence of pulmonary embolism was 17.6% (95% CI, 12.3%-23.5%), with a rate of 21.7% (95% CI, 14.8%-29.3%) in severe cases and 12.5% (95% CI, 6.1%-23.5%) in general cases. When COVID-19 severity was unclassified, the mortality for the patients with VTE was not significantly greater (25.2%; 95% CI, 12.2%-40.5%) than that for those without VTE (10.2%; 95% CI, 3.4%-19.5%; OR, 1.88; 95% CI, 0.46-7.64; P ¼ .377). However, among the patients with severe COVID-19, those who had developed VTE had significantly greater mortality compared with those without VTE (OR, 2.02; 95% CI, 1.15-3.53; P ¼ .014). The patients with COVID-19 and VTE had significantly higher D-dimer levels than did similar patients without VTE in multiple studies. Conclusions:The occurrence of VTE, DVT, and pulmonary embolism has been substantial among hospitalized patients with COVID-19, especially among those with severe COVID-19. Patients with severe COVID-19 and VTE had significantly greater mortality compared with similar patients without VTE. An increased D-dimer level might be an indicator of the occurrence of VTE in patients with COVID-19.

show abstract

Section: Discussionmentioning

confidence: 99%

A systematic review and meta-analysis of incidence, prognosis, and laboratory indicators of venous thromboembolism in hospitalized patients with coronavirus disease 2019

Liu

Cai

Wang

et al. 2021

Journal of Vascular Surgery: Venous and Lymphatic Disorders

View full text Add to dashboard Cite

show abstract

“…None of the RCTs correlated VTE with an anatomic location of pathology or type of operation hence no analysis could be done on the risk of VTE in these separate groups 6 . A recent systematic review on thromboprophylaxis after rectal cancer surgery found the prevalence of VTE to be lower than reported in historical accounts, especially if also undergoing minimally invasive surgery 1 . Another study based on ACS‐NQIP data showed colon cancer, especially metastatic cancer to be significantly associated with postoperative DVT, however, found no significant association with rectal cancer 2 .…”

Section: Methodsmentioning

confidence: 99%

“…6 A recent systematic review on thromboprophylaxis after rectal cancer surgery found the prevalence of VTE to be lower than reported in historical accounts, especially if also undergoing minimally invasive surgery. 1 Another study based on ACS-NQIP data showed colon cancer, especially metastatic cancer to be significantly associated with postoperative DVT, however, found no significant association with rectal cancer. 2 This raises the question of whether a subset of patients undergoing only rectal cancer surgery would also benefit from ETP.…”

Section: Future Recommendationsmentioning

confidence: 99%

“…Venous thromboembolism (VTE) presenting as a deep vein thrombosis (DVT) or pulmonary embolism (PE) is a significant, potentially preventable cause of morbidity and mortality in the post-operative setting of major abdominopelvic surgery. 1 This risk is especially increased in colorectal surgery where the majority of surgeries are performed for malignancy or inflammatory disease, both substantial independent risk factors for VTE. 2,3 VTE is promoted by venous stasis, vascular endothelium injury and hypercoagulability state, historically known as Virchow's Triad.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Extended chemothromboprophylaxis use in colorectal cancer surgery: a literature review

Chakraborty

Jacob

2022

ANZ Journal of Surgery

View full text Add to dashboard Cite

Venous thromboembolism (VTE) is a potentially fatal condition associated with chronic morbidity. Patients undergoing colorectal cancer surgery have an especially high rate of VTE postoperatively. This risk continues to be elevated for up to 3 months after discharge, hence arises the question of extended thromboprophylaxis (ETP). The objective of this literature review is to summarize the current literature on ETP post colorectal cancer surgery. The results of five randomized controlled trials (RCT), several meta-analysis and five major guidelines are outlined and examined. The literature overwhelmingly supports the use of ETP in colorectal cancer surgery. The key limitation of the evidence base is the use of objective tests to diagnose VTE which also detect asymptomatic events. However, this surrogate marker has been reliably shown to correlate with symptomatic VTE. In other high-risk populations such as orthopaedic patients, similar research has led to the use of routinely prescribed ETP. There is evidence now that the use of ETP is cost-effective in reducing morbidity and mortality from VTE in colorectal cancer patients. However, despite strong evidence on the benefits of ETP in colorectal cancer surgery, it is not yet a routine clinical practice. Future research is required to determine the optimal duration of chemothromboprophylaxis in different subgroups within colorectal cancer patients such as patients with rectal cancer only or those undergoing minimally invasive surgery.

show abstract

“…Minimally invasive surgery is coupled with the increased global utilization of elective enhanced recovery after surgery (ERAS) programmes that have reduced perioperative complications and hospital length of stay [ 25 , 26 ]. The current literature debates the effect that minimally invasive surgery has on VTE risk [ 27 , 28 , 29 , 30 ]. Reports state that prolonged operating times and iatrogenic pneumoperitoneum increase venous stasis, yet population‐based evidence from literature review suggests minimally invasive compared to open colectomy reduces VTE risk [ 31 , 32 , 33 ].…”

Section: Introductionmentioning

confidence: 99%

Time trends in the incidence rates of venous thromboembolism following colorectal resection by indication and operative technique

et al. 2022

View full text Add to dashboard Cite

Aim It is important for patient safety to assess if international changes in perioperative care, such as the focus on venous thromboembolism (VTE) prevention and minimally invasive surgery, have reduced the high post colectomy VTE risks previously reported. This study assesses the impact of changes in perioperative care on VTE risk following colorectal resection. Method This was a population‐based cohort study of colectomy patients in England between 2000 and 2019 using a national database of linked primary (Clinical Practice Research Datalink) and secondary (Hospital Episode Statistics) care data. Within 30 days following colectomy, absolute VTE rates per 1000 person‐years and adjusted incidence rate ratios (aIRRs) using Poisson regression for the per year change in VTE risk were calculated. Results Of 183 791 patients, 1337 (0.73%) developed 30‐day postoperative VTE. Overall, VTE rates reduced over the 20‐year study period following elective (relative risk reduction 31.25%, 95% CI 5.69%–49.88%) but not emergency surgery. Similarly, yearly changes in VTE risk reduced following minimally invasive resections (elective benign, aIRR 0.93, 95% CI 0.90–0.97; elective malignant, aIRR 0.94, 95% CI 0.91–0.98; and emergency benign, aIRR 0.96, 95% CI 0.92–1.00) but not following open resections. There was a per year VTE risk increase following open emergency malignant resections (aIRR 1.02, 95% CI 1.00–1.04). Conclusion Yearly VTE risks reduced following minimally invasive surgeries in the elective setting yet in contrast were static following open elective colectomies, and following emergency malignant resections increased by almost 2% per year. To reduce VTE risk, further efforts are required to implement advances in surgical care for those having emergency and/or open surgery.

show abstract

The prevalence of venous thromboembolism in rectal surgery: a systematic review and meta-analysis

Cited by 10 publications

References 59 publications

A systematic review and meta-analysis of incidence, prognosis, and laboratory indicators of venous thromboembolism in hospitalized patients with coronavirus disease 2019

A systematic review and meta-analysis of incidence, prognosis, and laboratory indicators of venous thromboembolism in hospitalized patients with coronavirus disease 2019

Extended chemothromboprophylaxis use in colorectal cancer surgery: a literature review

Time trends in the incidence rates of venous thromboembolism following colorectal resection by indication and operative technique

Contact Info

Product

Resources

About