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首页> 外文期刊>Colorectal disease: the official journal of the Association of Coloproctology of Great Britain and Ireland >Incidence of venous thromboembolic events in enhanced recovery after surgery for colon cancer: a retrospective, population‐based cohort study
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Incidence of venous thromboembolic events in enhanced recovery after surgery for colon cancer: a retrospective, population‐based cohort study

机译：发挥静脉血栓栓塞事件的发生率结肠癌手术后恢复:促成后悔rospective、人口为基础的队列研究

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Abstract Aim Both the Danish and the National Institute of Clinical Excellence ( NICE ) guidelines recommend prolonged thromboprophylaxis ( PT ) with low‐molecular‐weight heparin ( LMWH ) for 28?days postoperatively after elective surgery for colon cancer. The evidence relies on data from two randomized clinical trials ( RCT s) that included not only colon cancers but also other abdominal cancers or benign colorectal diseases. Neither of those studies investigated the risk of venous thromboembolism ( VTE ) under enhanced recovery after surgery ( ERAS ). We aim to describe the risk of VTE and estimate the cost of preventing one case of VTE by PT under ERAS . Method This was a retrospective study of 2230 patients undergoing elective surgery for colon cancer Stage I‐ III in the Capital Region of Denmark, 1 June 2008 to 31 December 2013. Patients who were discharged on postoperative day 28 or later, died during admission or were discharged with a vitamin K antagonist, novel oral anticoagulants or LMWH were excluded. Patients with rectal cancer only were not included. End‐points were symptomatic VTE diagnosed within 60?days postoperatively. Results Three‐hundred and thirty patients were excluded. For the remaining 1893, the median length of stay ( LOS ) was 4 [interquartile range ( IQR ): 3–5] days. Of these 1893 patients, four (0.20%) experienced a nonfatal symptomatic VTE . All four patients had other postoperative complications before the VTE . The cost of each symptomatic VTE prevented is estimated to be between ￡63?709 and ￡111?455 when medication and home‐care nursing are included. Conclusion The risk of symptomatic VTE after uncomplicated, elective surgery for colon cancer with ERAS seems negligible and the cost‐effectiveness of PT to prevent one symptomatic VTE seems questionable.
机译：摘要丹麦和国家目标临床优化研究所(NICE)指南建议延长thromboprophylaxis(PT)与低分子肝素(LMWH)重量应承担应承担的28日吗?手术结肠癌。数据来自两个随机临床试验(RCT)不仅包括结肠癌其他腹部肿瘤或良性结肠疾病。静脉血栓栓塞(VTE)的风险加强手术后恢复(时代)。描述静脉血栓栓塞的风险,估计成本预防静脉血栓栓塞的一个案例中PT的时代。这是一个2230年的回顾性研究方法对结肠癌病人择期手术癌症的阶段我三世在首都地区丹麦,1 2008年6月到2013年12月31日。患者在术后一天出院28日,死于或被承认与维生素K拮抗剂出院,小说口服抗凝血剂或LMWH被排除在外。直肠癌患者唯一的没有包括在内。诊断在60吗?三个几百,三十个患者被排除在外。剩余的1893,停留的平均时间(洛杉矶)4(四分位范围(差):3 - 5)天。经历了一个非致命的症状性静脉血栓栓塞。患者术后并发症静脉血栓栓塞。阻止估计之间￡63 ?￡111 ?是包括在内。静脉血栓栓塞后简单,选择性外科手术结肠癌与时代似乎可以忽略不计量PT的有效性,防止一个成本症状性静脉血栓栓塞似乎有问题。

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