title: Incidence and risk factors of venous thromboembolism in colorectal surgery: does laparoscopy impart an advantage?
abstract: OBJECTIVE
  Laparoscopy is increasingly used in colon and rectal procedures. However, little is known regarding the incidence of venous thromboembolism (VTE) in laparoscopic colorectal (LC) compared with that in open colorectal (OC) procedures. We aimed to compare the incidences and to highlight the risk factors of developing VTE after LC and OC surgery.
  
  
  METHODS
  Analysis of the Nationwide Inpatient Sample data from 2002 through 2006.
  
  
  METHODS
  National database.
  
  
  METHODS
  Patients who underwent elective LC and OC surgery from 2002 through 2006.
  
  
  METHODS
  Incidence of VTE during initial hospitalization after LC and OC surgery; VTE classified by surgical site, pathology type, and at-risk patient population.
  
  
  RESULTS
  Over a 60-month period, 149,304 patients underwent LC or OC resection. Overall, the incidence of VTE was significantly higher in OC cases (2036 of 141,456 [1.44%]) compared with the incidence in LC cases (65 of 7848 [0.83%]) (P < .001). When stratified according to pathologic condition and surgical site, the overall rate of VTE was highest in patients with inflammatory bowel disease and in those undergoing rectal resections. Patients who underwent OC surgery were almost twice as likely to develop VTE compared with patients who underwent LC surgery. We also identified malignancy, obesity, and congestive heart failure as statistically significant (P < .05) risk factors for VTE in OC and LC surgery.
  
  
  CONCLUSIONS
  On the basis of data from a large clinical data set, the incidence of perioperative VTE is lower after LC than after OC surgery. These findings may help colorectal surgeons use appropriate VTE prophylaxis for patients undergoing colorectal procedures.
authors.affiliation: University of California-Irvine Medical Center, Orange, CA 92868, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Buchberg
authors.forename: Hossein
authors.initials: H
authors.lastname: Masoomi
authors.forename: Kristelle
authors.initials: K
authors.lastname: Lusby
authors.forename: John
authors.initials: J
authors.lastname: Choi
authors.forename: Andrew
authors.initials: A
authors.lastname: Barleben
authors.forename: Cheryl
authors.initials: C
authors.lastname: Magno
authors.forename: John
authors.initials: J
authors.lastname: Lane
authors.forename: Ninh
authors.initials: N
authors.lastname: Nguyen
authors.forename: Steven
authors.initials: S
authors.lastname: Mills
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Stamos
mesh_terms: D003082:Colectomy / Q000009:adverse effects* / Q000379:methods; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000601:surgery*; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000209:etiology*