Analysis of Correlation Factors of Lower Limb Deep Venous Thrombosis after Laparoscopic Surgery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YANG Lin ¹ , CAI Duan ¹ , QI Guangyu ²

1.Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040;;
2.Department of General Surgery, The First Affiliated Hospital, Medical College, Xi’an Jiaotong University, Xi’an 710061;

Corresponding author：

Keywords：

Laparoscope; Deep venous thrombosis; High risk factor; Operation time; Operative site; Diagnosis; Prevention

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Objective To investigate the correlated risk factors of deep venous thrombosis (DVT) after the laparoscopic surgery. Methods Clinical records of 16 patients with DVT and 148 patients without DVT after laparoscopic surgery in Huashan hospital from Mar.2007 to Jan.2008 were analyzed retrospectively. Results There were several factors which could induce DVT after the laparoscopic surgery, including operation time ＞1 h 〔OR=4.15 （95% CI： 1.36-12.68）〕, operative site located in hypogastrium 〔OR=2.94 （95% CI： 1.07-8.08）〕 and the number of high risk factors ≥3 〔OR=3.94 （95% CI： 1.38-11.23）〕. Conclusions The long time of operation， hypogastric operation of laparoscopic surgery and high risk factors could induce DVT. Prevention measures should be made in preoperative period.

Citation： YANG Lin,CAI Duan,QI Guangyu. Analysis of Correlation Factors of Lower Limb Deep Venous Thrombosis after Laparoscopic Surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(6): 425-428. doi: Copy

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22.	王海波，闫西红，高丽彩, 等. 低分子肝素钙预防肥胖患者妇科腹腔镜手术后深静脉血栓形成的临床研究 [Ｊ]. 中国内镜杂志， 2008； 14(3)： 266-268.

1. 张培华，蒋米尔主编. 临床血管外科学 [Ｍ]. 第2版. 北京：科学出版社， 2007: 568.
2. 冯力民，夏恩兰. 腹腔镜术后深静脉血栓的研究 [Ｊ]. 中国内镜杂志， 1999； 5(4)： 20-22.
3. 张勇，陈延山，王义欣，等. 腹腔镜胆囊切除术后静脉血栓12例分析 [Ｊ]. 中国微创外科杂志， 2005； 5(11)： 888-889.
4. 肖刚. 腹腔镜术后下肢静脉血栓28例分析 [Ｊ]. 腹腔镜外科杂志， 2006； 11(6)： 508-509.
5. Jorgensen JO, Hanel K, Lalak NJ, et al. Thromboembolic complications of laparoscopic cholecystectomy [Ｊ]. BMJ, 1993; 306(6876): 518-519.
6. Brown JA, Garlitz C, Gomella LG, et al. Perioperative morbidity of laparoscopic radical prostatectomy compared with open radical retropubic prostatectomy [Ｊ]. Urol Oncol, 2004; 22(2): 102-106.
7. 陈平康, 徐志成, 过建工，等. 腹腔镜胆囊切除术后下肢静脉血栓形成 [Ｊ]. 生物医学工程与临床, 2001; 5(3): 157.
8. Patel MI, Hardman DT, Nicholls D, et al. The incidence of deep venous thrombosis after laparoscopic cholecystectomy [Ｊ]. Med J Aust, 1996; 164(11): 652-654, 656.
9. Milic DJ, Pejcic VD, Zivic SS, et al. Coagulation status and the presence of postoperative deep vein thrombosis in patients undergoing laparoscopic cholecystectomy [Ｊ]. Surg Endosc, 2007; 21(9): 1588-1592.
10. Ikeda M, Sekimoto M, Takiguchi S, et al. High incidence of thrombosis of the portal venous system after laparoscopic splenectomy: a prospective study with contrast-enhanced CT scan [Ｊ]. Ann Surg, 2005; 241(2): 208-216.
11. Maíllo CL, Martín E, López J, et al. Effect of pneumoperitoneum on venous hemodynamics during laparoscopic cholecystectomy. Influence of patients’ age and time of surgery [Ｊ]. Med Clin (Barc), 2003; 120(9): 330-334.
12. Fuchs S, Heyse T, Rudofsky G, et al. Continuous passive motion in the prevention of deep-vein thrombosis: a randomised comparison in trauma patients [Ｊ]. J Bone Joint Surg Br, 2005; 87(8): 1117-1122.
13. Okuda Y, Kitajima T, Egawa H, et al. A combination of heparin and an intermittent pneumatic compression device may be more effective to prevent deep-vein thrombosis in the lower extremities after laparoscopic cholecystectomy [Ｊ].Surg Endosc, 2002; 16(5): 781-784.
14. 王秋生，张阳德译. 内镜腹腔镜外科学 [Ｍ]. 北京: 中国医药科技出版社， 2001: 28.
15. 马玉奎，赵纪春，胡志，等, 下肢深静脉血栓形成的诊断及综合治疗 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(1): 56-58.
16. 胡大一，孙艺红. 血栓栓塞性疾病的规范防治——ACCP最新溶栓和抗栓指南的启示 [Ｊ]. 临床荟萃， 2005； 20(15)：841-843.
17. Ginzburg E, Cohn SM, Lopez J, et al. Randomized clinical trial of intermittent pneumatic compression and low molecular weight heparin in trauma [Ｊ]. Br J Surg, 2003; 90(11): 1338-1344.
18. Colditz GA, Tuden RL, Oster G. Rates of venous thrombosis after general surgery: combined results of randomised clinical trials [Ｊ]. Lancet, 1986; 2(8499): 143-146.
19. Flam E, Berry S, Coyle A, et al. Blood-flow augmentation of intermittent pneumatic compression systems used for prevention of deep vein thrombosis prior to surgery [Ｊ]. Am J Surg, 1996; 171(3): 312-315.
20. Schaepkens Van Riempst JT, Van Hee RH, Weyler JJ. Deep venous thrombosis after laparoscopic cholecystectomy and prevention with nadroparin [Ｊ]. Surg Endosc, 2002; 16(1): 184-187.
21. 李友伟，何平，李生伟. 老年患者腹腔镜胆囊切除术后下肢深静脉血栓形成的预防 [Ｊ]. 临床误诊误治， 2008； 21(4)：62-63.
22. 王海波，闫西红，高丽彩, 等. 低分子肝素钙预防肥胖患者妇科腹腔镜手术后深静脉血栓形成的临床研究 [Ｊ]. 中国内镜杂志， 2008； 14(3)： 266-268.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of Correlation Factors of Lower Limb Deep Venous Thrombosis after Laparoscopic Surgery

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