Malignancy and surgery are risk factors for venous thromboembolism (VTE). We undertook a systematic review of the literature concerning the prophylactic management of VTE in orthopaedic oncology patients. MEDLINE (PubMed), EMBASE (Ovid), Cochrane, and CINAHL databases were searched focusing on VTE, deep vein thrombosis (DVT), pulmonary embolism (PE), bleeding, or wound complication rates.Aims
Methods
The aim of this study was to define the incidence
of venous thromboembolism (VTE) and risk factors for the development
of deep-vein thrombosis (DVT) after the resection of a musculoskeletal
tumour. A total of 94 patients who underwent resection of a musculoskeletal
tumour between January 2003 and December 2005 were prospectively
studied. There were 42 men and 52 women with a mean age of 54.4
years (18 to 86). All patients wore intermittent pneumatic compression
devices and graduated compression stockings. Ultrasound examination
of the lower limbs was conducted to screen for DVT between the fifth
and ninth post-operative days. DVT was detected in 21 patients (22%). Of these, two were symptomatic
(2%). One patient (1%) had a fatal pulmonary embolism. Patients
aged ≥ 70 years had an increased risk of DVT (p = 0.004). The overall incidence of DVT (both symptomatic and asymptomatic)
after resection of a musculoskeletal tumour with mechanical prophylaxis
was high. It seems that both mechanical and anticoagulant prophylaxis
is needed to prevent VTE in patients who have undergone the resection
of a musculoskeletal tumour. Cite this article:
It is important to be able to identify patients
with an increased risk of venous thromboembolism (VTE) in order
to minimise the risk of an event. We investigated the incidence
and risk factors for post-operative VTE in 168 consecutive patients
with a malignancy of the lower limb. The period of study included
ten months before and 12 months after the introduction of chemical
thromboprophylaxis. All data about the potential risk factors were identified
and classified into three groups (patient-, surgery- and tumour-related).
The outcome measure was a thromboembolic event within 90 days of
surgery. Of the 168 patients, eight (4.8%) had a confirmed symptomatic
deep-vein thrombosis and one (0.6%) a fatal pulmonary embolism.
Of the 28 variables tested, age >
60 years, higher American Society
of Anesthesiologists grade and metastatic tumour were independent
risk factors for VTE. The overall rate of symptomatic VTE was not significantly
different between patients who received chemical thromboprophylaxis
and those who did not. Knowledge of these risk factors may be of
value in improving the surgical outcome of patients with a malignancy
of the lower limb. Cite this article:
