[The problem of postoperative venous thromboembolic complications in general surgery].
The paper reviews occurrence, diagnostic tools venous thromboembolic complications. Cost effectiveness of preventive measures for venous thrombosis and pulmonary embolism in general surgery is analysed. The study included 45 patients who underwent elective (21) and urgent (24) abdominal and pelvic interventions. Each patient was examined with ultrasonic with color Doppler imaging before and 8-10 days after surgery. Deep venous thrombosis of lower limbs was diagnosed in 11.1%, most of cases being asymptomatic. Ultrasonic angioscanning appeared to be an acute and reliable diagnostic tool for this pathology. Various approaches to the management of patients at thrombotic risk are reviewed. Cost effectiveness analysis of anticoagulation prevention for postoperative venous thromboembolic complications must address the problem: is prevention outcome worth those extra efforts? Surveillance of 500 patients at high thrombotic risk has shown that preventive use of low weight heparin (Clexane) is economically beneficial then conventional Heparin, the more in the absence of special preventive strategy. Targeted prevention in patients with different risk of postoperative venous thromboembolic complications can yield more then 3-fold reduction in occurrence of these complications.
Kirienko
A I
AI
Pediatric Department, Medical University, Moscow, Russia.
Mishnev
O D
OD
Tsitsiashvili
M Sh
MSh
Agafonov
V F
VF
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D013505:Digestive System Surgical Procedures; D017984:Enoxaparin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012307:Risk Factors; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control*
D000925:Anticoagulants; D017984:Enoxaparin