Thromboembolism in patients undergoing thoracotomy

Area of Science:

• Cardiovascular Medicine
• Thoracic Surgery
• Oncology

Background:

• Thoracotomy is a major surgical procedure with potential risks.
• Thromboembolic events, including deep venous thrombosis and pulmonary embolism, are significant complications.
• Understanding the incidence and risk factors for these events is crucial for patient management.

Purpose of the Study:

• To determine the incidence of thromboembolic events following thoracotomy.
• To identify risk factors associated with postoperative thromboembolism.
• To evaluate the potential benefit of preoperative aspirin or ibuprofen in preventing these events.

Main Methods:

• Prospective study of 77 patients undergoing pulmonary resection.
• Monitoring for deep venous thrombosis and pulmonary embolism up to 30 days postoperatively.
• Analysis of patient data including cancer type, tumor size, stage, and surgical procedure.

Main Results:

• Overall thromboembolic event incidence was 26% (20/77).
• Postoperative incidence was 19% (15/77), with deep venous thrombosis in 14% and pulmonary embolism in 5%.
• No thromboembolic events occurred in patients receiving preoperative aspirin or ibuprofen (n=17), compared to 25% in others (15/60).

Conclusions:

• Thromboembolism after pulmonary resection is more frequent in patients with bronchogenic carcinoma, adenocarcinoma, larger tumors, advanced stage, and major resections (pneumonectomy/lobectomy).
• Preoperative aspirin or ibuprofen may reduce postoperative thromboembolic events.
• Patients undergoing thoracotomy for lung cancer, particularly adenocarcinoma, should be considered for thromboembolic prophylaxis.