title: Comparison of bleeding risks related to venous thromboembolism prophylaxis in laparoscopic vs open colorectal cancer surgery: a multicenter study in Japanese patients.
abstract: BACKGROUND
  Venous thromboembolism is the most common preventable cause of hospital death. The objective of this study was to clarify risk factors for postoperative bleeding related to thromboprophylaxis after laparoscopic colorectal cancer surgery.
  
  
  METHODS
  The study was conducted at 23 Japanese institutions and included patients with colorectal cancer who underwent laparoscopic or open surgery followed by fondaparinux treatment. We performed a retrospective analysis from a prospectively maintained database. We used multivariate analyses to evaluate clinical risk factors for prophylaxis-related bleeding events.
  
  
  RESULTS
  After multivariate analysis, male gender, intraoperative blood loss of less than 25 mL, and a preoperative platelet count below 15 × 104/μL were found to be independent risk factors in the laparoscopic surgery group. Only the preoperative platelet count was an independent risk factor in the open surgery group.
  
  
  CONCLUSIONS
  Different prophylactic treatments for postoperative venous thromboembolism may be necessary in laparoscopic vs open surgery for colorectal cancer.
authors.affiliation: Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-Ku, Osaka City, Osaka 537-8511, Japan. Electronic address: myasui-gi@umin.ac.jp.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Yasui
authors.affiliation: Department of Surgery, National Hospital Organization, Osaka National Hospital, Osaka City, Osaka, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Ikeda
authors.affiliation: Department of Surgery, National Hospital Organization, Osaka National Hospital, Osaka City, Osaka, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Miyake
authors.affiliation: Department of Surgery, Yao Municipal Hospital, Yao City, Osaka, Japan.
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Ide
authors.affiliation: Department of Surgery, Higashiosaka City General Hospital, Higashiosaka City, Osaka, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Okuyama
authors.affiliation: Department of Surgery, Saiseikai Senri Hospital, Suita City, Osaka, Japan.
authors.forename: Tatsushi
authors.initials: T
authors.lastname: Shingai
authors.affiliation: Department of Surgery, Nara Hospital Kinki University Faculty of Medicine, Ikoma City, Nara, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Kitani
authors.affiliation: Department of Surgery, Osaka Rosai Hospital, Sakai City, Osaka, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ikenaga
authors.affiliation: Department of Surgery, Osaka Rosai Hospital, Sakai City, Osaka, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Hasegawa
authors.affiliation: Department of Surgery, Osaka Police Hospital, Osaka City, Osaka, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Akamatsu
authors.affiliation: Department of Surgery, Suita Municipal Hospital, Suita City, Osaka, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Murata
authors.affiliation: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Takemasa
authors.affiliation: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.
authors.forename: Tsunekazu
authors.initials: T
authors.lastname: Mizushima
authors.affiliation: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yamamoto
authors.affiliation: Department of Surgery, National Hospital Organization, Osaka National Hospital, Osaka City, Osaka, Japan.
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Sekimoto
authors.affiliation: Department of Surgery, Nishinomiya Municipal Central Hospital, Nishinomiya City, Hyogo, Japan.
authors.forename: Riichiro
authors.initials: R
authors.lastname: Nezu
authors.affiliation: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.affiliation: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D000077425:Fondaparinux; D006801:Humans; D007564:Japan; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides / Q000627:therapeutic use*; D019106:Postoperative Hemorrhage / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D011134:Polysaccharides; D000077425:Fondaparinux
keywords: Bleeding; Colorectal surgery; Laparoscopy; Prophylaxis; VTE