title: Postsurgery outcomes in patients with polycythemia vera and essential thrombocythemia: a retrospective survey.
abstract: A multicenter retrospective analysis was performed to estimate the frequency of thrombosis and hemorrhage after surgical procedures in patients with polycythemia vera (PV) and patients with essential thrombocythemia (ET). Data from 105 patients with PV and 150 patients with ET were analyzed, for a total of 311 surgical interventions. An emergency procedure was performed in 25 (8.1%) patients; 194 surgeries were done under general anesthesia, and 21 (23%) of 91 abdominal interventions were done under laparoscopy; 155 (50.1%) were major surgeries. Subcutaneous heparin was administered in 169 (54.3%) of 311 cases and antiplatelet therapy in 48 (15.4%) of 311 case interventions. One hundred eighty-eight (74%) of 255 patients were on cytoreductive therapy before surgery. No events were observed in 259 (83.2%) of 311 procedures during 3 months of follow-up; there were 12 arterial and 12 venous thrombotic events, 23 major and 7 minor hemorrhages, and 5 deaths. Arterial thromboses were more frequent in ET (5.3% vs 1.5%; P=.08), venous events were more frequent in PV (7.7% vs 1.1%; P=.002). There was not a correlation between bleeding episodes and the type of diagnosis, use of antithrombotic prophylaxis, or type of surgery. A high proportion of PV and ET surgeries was complicated by vascular occlusion (7.7%) or by a major hemorrhage (7.3%). Prospective investigations analyzing the optimal prophylaxis in these patients are suggested.
authors.affiliation: Department of Hematology, San Bortolo Hospital, Vicenza, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Ruggeri
authors.forename: Francesco
authors.initials: F
authors.lastname: Rodeghiero
authors.forename: Alberto
authors.initials: A
authors.lastname: Tosetto
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Castaman
authors.forename: Francesca
authors.initials: F
authors.lastname: Scognamiglio
authors.forename: Guido
authors.initials: G
authors.lastname: Finazzi
authors.forename: Federica
authors.initials: F
authors.lastname: Delaini
authors.forename: Caterina
authors.initials: C
authors.lastname: Micò
authors.forename: Alessandro M
authors.initials: AM
authors.lastname: Vannucchi
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Antonioli
authors.forename: Valerio
authors.initials: V
authors.lastname: De Stefano
authors.forename: Tommaso
authors.initials: T
authors.lastname: Za
authors.forename: Luigi
authors.initials: L
authors.lastname: Gugliotta
authors.forename: Alessia
authors.initials: A
authors.lastname: Tieghi
authors.forename: Maria Gabriella
authors.initials: MG
authors.lastname: Mazzucconi
authors.forename: Cristina
authors.initials: C
authors.lastname: Santoro
authors.forename: Tiziano
authors.initials: T
authors.lastname: Barbui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011087:Polycythemia Vera / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000401:mortality / Q000517:prevention & control; D012189:Retrospective Studies; D013920:Thrombocythemia, Essential / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D013927:Thrombosis / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D006493:Heparin