Analysis of the risk of venous thromboembolism in the perioperative period of radical cystectomy
Objective:Patients undergoing radical cystectomy(RC)are often at risk of venous thrombosis after surgery,which not only prolongs hospitalization but may also lead to serious complications,such as pulmonary embolism.The aim of this study was to explore the probability of perioperative venous thromboembolism(VTE)events and their associated risk factors in patients undergoing radical total cystectomy in the real world,and to provide guidance on clinical management.Methods:Data related to patients who underwent RC in the Department of Urology at the Second Hospital of Tianjin Medical University between January 2022 and December 2023 were collected.The corresponding inclusion and exclusion criteria were established.The statistical data information was validated byx2,logistic analysis,and Student t test.Results:Information was collected on 88 patients with a me-dian age of 71 years including 72 males and 16 females.Perioperative VTE events were diagnosed in 33 patients(37.5％)and postoperative VTE events were diagnosed in 26 patients(29.5％),of which 2 cases were progres-sion of preoperative venous thrombosis.After analyzing the effect of various factors on perioperative VTE we found that smoking,previous history of thromboembolism were background risk factors in venous thrombosis(P=0.002,P=0.01).For postoperative venous thrombosis,the length of preoperative low molecular heparin application(P=0.01),and the presence or absence of lithotomy maneuver(P=0.034)were risk factors affecting the probability of its occurrence.Conclusion:Patients with a history of thromboembolism and smoking should be focused on prophylactic interventions for perioperative thrombosis,and the perioperative prophylactic anticoagula-tion regimen needs to be further improved while controlling the duration of the surgery,including,but not limited to,perioperative low molecular heparin,anti-thrombotic elastic stockings,lower extremity massage,and early ac-tivity.Prospective studies are also recommended to further explore the effects of perioperative prophylactic antico-agulation on venous thrombosis and to guide the medication regimen.
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