Are sequential compression devices routinely necessary following enhanced recovery after thoracic surgery?

Area of Science:

• Thoracic Surgery
• Vascular Surgery
• Critical Care Medicine

Background:

• Enhanced Recovery After Surgery (ERAS) protocols are increasingly adopted in thoracic surgery.
• Mechanical venous thromboembolism (VTE) prophylaxis guidelines require re-evaluation in this context.
• Sequential Compression Devices (SCDs) are commonly used for VTE prevention.

Purpose of the Study:

• To assess the role of SCDs in preventing VTEs in thoracic surgical patients.
• To evaluate the effectiveness of SCDs within ERAS protocols.
• To determine if SCDs are essential for VTE prophylaxis in this patient population.

Main Methods:

• A retrospective study of 200 patients undergoing elective oncological thoracic surgery.
• Two cohorts were compared: one using SCDs and one without, both adhering to ERAS protocols.
• VTE incidence and severity were evaluated, with Caprini Score (CS) and Charlson Comorbidity Index (CCI) used for comparison.

Main Results:

• Only 2 patients in the SCD group developed pulmonary embolism (PE), both post-discharge.
• No significant difference in Caprini Score or Charlson Comorbidity Index between the SCD and non-SCD groups.
• Equivalence in CS and CCI was demonstrated between the cohorts (P < 0.001).

Conclusions:

• Routine use of SCDs may not be required for thoracic surgery patients on ERAS protocols.
• Clinically significant VTE rates were minimal in patients managed with ERAS, irrespective of SCD use.
• Larger studies are needed to confirm these findings and refine VTE prophylaxis strategies.