Risk Factors of Venous Thromboembolism after Colorectal Cancer Surgery

Venous thromboembolism (VTE) is a common and serious complication following colorectal cancer surgery. According to the current data, the incidence of VTE ranges from 0.6 to 26.3%. The data on risk factors for VTE in this cohort of patients are controversial. Objective. To determine the incidence and risk factors for VTE in patients who underwent surgery for colorectal cancer. Material and methods. A total of 137 subjects were enrolled in our retrospective study. We included patients who had surgery for colorectal cancer in Savelyev University Surgery Clinic from January 2016 to December 2017. Compression duplex ultrasound of the lower extremity veins was performed before and after surgery in all participants. The primary endpoint was the occurrence of VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE). Results. VTE was detected in 32 patients (23.4%). All subjects received standard pharmacological prophylaxis with anticoagulants. There were 4 (2.9%) proximal and 28 (20.5%) distal DVT. In addition, 2 proximal and 3 distal DVT were symptomatic. There were no cases of symptomatic pulmonary embolism. It was found in multivariate Cox proportional hazard model that T criterion of TNM classification (HR 2.18, 95% CI 1.05—4.5, p=0.036) and history of VTE (HR 4.84, 95% CI 1.19—19.7, p=0.028) were statistically significant risk factors in patients after colorectal cancer surgery. Conclusion. The incidence of postoperative VTE in patients after colorectal cancer surgery is high with a predominantly distal DVT of the lower extremities as a thrombotic event. The value of T criterion of TNM classification and history of VTE are risk factors for these complications after colorectal cancer surgery.