Incidence of Venous Thromboembolism After Oral Oncologic Surgery With Simultaneous Reconstruction.
OBJECTIVE
Patients with oral cancer who undergo resection with simultaneous reconstruction are presumed to be at high risk for developing venous thromboembolism (VTE) according to current criteria. The primary purpose of this retrospective study was to report the incidence of VTE after oral cancer surgery requiring primary reconstruction and to identify the potential risk factors for VTE in this population.


METHODS
This retrospective study evaluated 133 consecutive patients who had undergone oral cancer resection with simultaneous reconstruction from April 2007 through December 2014. Bilateral lower-extremity venous duplex ultrasonography (VDUS) was routinely performed 2 days after surgery. Pulmonary embolism was confirmed with computed tomography. The Caprini risk score (CRS) was obtained for each patient. Patients with and without VTE were compared using the χ2 test and Student t test with some variables. Univariate predictors associated with VTE were entered into a multivariate logistic regression analysis. A P value less than .05 was regarded as indicating statistical significance.


RESULTS
The incidence of VTE after oral oncologic surgery with simultaneous reconstruction was 26.3% (35 of 133 patients): deep vein thrombosis (DVT) and pulmonary embolism occurred in 2.3% (3 of 133) and DVT alone was found in 24.0% (32 of 133). Multivariate logistic regression analysis showed that only a high CRS was statistically relevant to VTE occurrence.


CONCLUSIONS
Because a high incidence of VTE was found after major oral and maxillofacial surgery, lower-extremity VDUS should be undertaken in patients who undergo oral cancer surgery with simultaneous reconstruction, especially those with a high CRS.
Graduate Fellow, Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Yasumasa
Y
Kakei
Assistant Professor, Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: akashim@med.kobe-u.ac.jp.
Masaya
M
Akashi
Assistant Professor, Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Takumi
T
Hasegawa
Lecturer, Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Tsutomu
T
Minamikawa
Associate Professor, Faculty of Human Sciences, University of Tsukuba, Tsukuba, Japan.
Satoshi
S
Usami
Professor and Chairman, Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Takahide
T
Komori
D000328:Adult; D016025:Bone Transplantation / Q000706:statistics & numerical data; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000637:transplantation; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D035002:Lower Extremity / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D018482:Muscle, Skeletal / Q000637:transplantation; D011183:Postoperative Complications / Q000453:epidemiology; D011655:Pulmonary Embolism / Q000453:epidemiology; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D013524:Surgical Flaps / Q000637:transplantation; D014057:Tomography, X-Ray Computed / Q000379:methods; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods; D054556:Venous Thromboembolism / Q000453:epidemiology*; D020246:Venous Thrombosis / Q000453:epidemiology