A study of pulmonary embolism after abdominal surgery in patients undergoing prophylaxis

作     者：Mirko D Kerkez Dorde M ulafi Dragana D Mija Vitomir I Rankovi Nebja S Leki Dejan Z Stefanovi 

作者机构：Clinic of Surgery Institute of Digestive DiseasesClinical Center of SerbiaMedical Faculty11000 BelgradeRepublic of Serbia Clinic of Gastroenterology and HepatologyInstitute of Digestive DiseasesClinical Center of SerbiaMedical Faculty11000 BelgradeRepublic of Serbia 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2009年第15卷第3期

页      面：344-348页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Author contributions: Kerkez MD  Culafic DM  Mijac DD contributed equally to this work Kerkez MD  Culafic DM  Mijac DD  Rankovic VI  Lekic NS  Stefanovic DZ designed the research Kerkez MD  Culafic DM  Rankovic VI  Lekic NS  Stefanovic DZ performed the research as surgeons  anesthesiologist and colonoscopist Lekic NS  Stefanovic DZ contributed new reagents/analytic tools Kerkez MD  Culafic DM  Mijac DD analyzed the data and wrote the paper 

主　　题：Pulmonary embolism Surgery Colorectal cancer Risk factor Prevention 

摘      要：AIM： To determine risk factors for pulmonary embolism and estimate effects and benefits of prophylaxis. METHODS： We included 78 patients who died subsequently to a pulmonary embolism after major abdominal surgery from 1985 to 2003. A first, retrospective analysis involved 41 patients who underwent elective surgery between 1985 and 1990 without receiving any prophylaxis. In the prospectively evaluated subgroup, 37 patients undergoing major surgery between 1991 and 2003 were enrolled： all of them had received a prophylaxis consisting in lowmolecular weight heparin, given subcutaneously at a dose of 2850 IU AXa/0.3 mL （body weight 〈 50 kg） or 5700 IU AXa/0.6 mL （body weight ≥ 50 kg）. RESULTS： A higher incidence of thromboembolism （43.9% and 46.34% in the two groups, respectively） was found in older patients （〉 60 years）. The incidence of pulmonary embolism after major abdominal surgery in patients who had received the prophylaxis was significantly lower compared to the subjects with the same condition who had not received any prophylaxis （P 〈 0.001, OR = 2.825; 95% CI, 1.811-4.408）. Furthermore, the incidence of pulmonary embolism after colorectal cancer surgery was significantly higher compared to incidence of pulmonary embolism after other abdominal surgical procedures. Finally, the incidence of pulmonary embolism after colorectal cancer surgery among the patients who had received the prophylaxis （11/4316, 0.26%） was significantly lower compared to subjects undergoing a surgical procedure for the same indication but without prophylaxis （10/1562, 0.64%） （P 〈 0.05, OR = 2.522; 95% Ct, 1.069-5.949）. CONCLUSION： Prophylaxis with low molecular weight heparin is highly recommended during the preoperative period in patients with diagnosis of colorectal cancer due to high risk of pulmonary embolism after elective surgery.