Postsurgery outcomes in patients with polycythemia vera and essential thrombocythemia: a retrospective survey.
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.
Ruggeri
Marco
M
Department of Hematology, San Bortolo Hospital, Vicenza, Italy.
Rodeghiero
Francesco
F
Tosetto
Alberto
A
Castaman
Giancarlo
G
Scognamiglio
Francesca
F
Finazzi
Guido
G
Delaini
Federica
F
Micò
Caterina
C
Vannucchi
Alessandro M
AM
Antonioli
Elisabetta
E
De Stefano
Valerio
V
Za
Tommaso
T
Gugliotta
Luigi
L
Tieghi
Alessia
A
Mazzucconi
Maria Gabriella
MG
Santoro
Cristina
C
Barbui
Tiziano
T
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
D000925:Anticoagulants; D006493:Heparin