title: Incidence of and risk factors for preoperative deep venous thrombosis in patients undergoing gastric cancer surgery.
abstract: BACKGROUND
  Pulmonary thromboembolism (PE) is one of the life-threatening complications of gastric cancer surgery. D-dimer assay is a safe and rapid tool to exclude the presence of deep venous thrombosis (DVT). In July 2012, we started preoperative DVT screening of patients scheduled for gastric cancer surgery using a combination of D-dimer measurements and lower extremity venous ultrasonography to prevent PE.
  
  
  METHODS
  Between July 2012 and August 2015, 976 consecutive patients underwent gastric cancer surgery with preoperative D-dimer screening. Lower extremity venous ultrasonography was performed in patients with a positive D-dimer assay result (greater than 1.0 μg/ml). The incidence of and risk factors for preoperative DVT and the incidence of PE were examined in patients undergoing gastric cancer surgery.
  
  
  RESULTS
  Of the 976 patients, 176 (18.0%) showed positive D-dimer assay results, and in 13 (1.3%) DVT was diagnosed by lower extremity ultrasonography. Our analysis identified neoadjuvant chemotherapy as a risk factor for preoperative detection of DVT in patients undergoing gastric cancer surgery (P = 0.021). The incidence of PE was 0.1% (1/976).
  
  
  CONCLUSIONS
  Preoperative gastric cancer patients receiving neoadjuvant chemotherapy seem to be at higher risk for the development of DVT.
authors.affiliation: Gastric Surgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan.
authors.forename: Takeyuki
authors.initials: T
authors.lastname: Wada
authors.affiliation: Gastric Surgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan.
authors.forename: Hisataka
authors.initials: H
authors.lastname: Fujiwara
authors.affiliation: Gastric Surgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Morita
authors.affiliation: Gastric Surgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Fukagawa
authors.affiliation: Gastric Surgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan. hkatai@ncc.go.jp.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Katai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D015994:Incidence; D035002:Lower Extremity / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000601:surgery*; D014463:Ultrasonography / Q000379:methods; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control
chemical_list: D000970:Antineoplastic Agents; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D
keywords: D-dimer; Deep venous thrombosis; Gastric cancer