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Surg Endosc 2022 Jun 9. Epub 2022 Jun 9.

South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK.

Background: There is a lack of published data on variations in practices concerning laparoscopic cholecystectomy. The purpose of this study was to capture variations in practices on a range of preoperative, perioperative, and postoperative aspects of this procedure.

Methods: A 45-item electronic survey was designed to capture global variations in practices concerning laparoscopic cholecystectomy, and disseminated through professional surgical and training organisations and social media. Read More

World J Clin Cases 2022 Apr;10(10):3035-3046

The Fifth Ward of Surgery, Kunshan Hospital of Traditional Chinese Medicine, Kunshan 215300, Jiangsu Province, China.

Background: Venous thromboembolism (VTE) is a major cause of unexpected and perioperative in-hospital deaths. It is characterized by high morbidity, high mortality, high misdiagnosis rate, and high missed diagnosis rates. VTE is a common postoperative complication in cancer patients. Read More

HSS J 2022 May 8;18(2):212-218. Epub 2021 Nov 8.

Hospital for Special Surgery, New York, NY, USA.

Patients with a history of venous thromboembolism (VTE) undergoing total knee arthroplasty (TKA) are at a high risk of postoperative VTE. In this high-risk population, we sought to evaluate the safety and efficacy of multimodal thromboprophylaxis. The regimen consisted of discontinuation of procoagulant medications, VTE risk stratification, regional anesthesia, rapid mobilization, perioperative use of pneumatic compression devices, vigorous ankle dorsiflexion during the recovery period, and chemoprophylaxis tailored to the patient's risk of VTE. Read More

Ann Med Surg (Lond) 2022 May 6;77:103546. Epub 2022 Apr 6.

Senior Training Fellow in Trauma and Orthopaedics, Royal Stoke University Hospitals, Stoke on Trent, UK.

Background: Since their introduction, arthroscopic procedures have been increasingly utilized for the treatment of knee pathologies, especially Anterior Cruciate Ligament (ACL) reconstruction. Reduction of post-operative morbidity, shortened hospital stay and recovery period have all been identified as the benefits of arthroscopy. However, despite tremendous increase in the number of these procedures done, the postoperative complications associated have been infrequently analyzed. Read More

Cureus 2022 Apr 22;14(4):e24388. Epub 2022 Apr 22.

Department of Orthopaedic Surgery, Emory University, Atlanta, USA.

Background Tibial plateau fractures are often significant injuries that can require complex surgical interventions with prolonged perioperative immobilization, thereby increasing the risk of developing venous thromboembolic (VTE) events, specifically, deep vein thrombosis (DVT) and pulmonary embolism (PE). Risk stratification is paramount for guiding VTE prophylaxis. Although high altitude has been suggested to create a prothrombotic state, virtually no studies have explored its clinical effects in lower extremity trauma. Read More

Zhongguo Gu Shang 2022 Apr;35(4):349-52

Department High and New Orthopaedics Zhengzhou Central Hospital, Zhengzhou 450000, Henan, China.

Objective: To explore the effect of intermittent pneumatic compression(IPC) combined with 3M thermometer on the prevention of deep venous thrombosis(DVT) in patients with femoral intertrochanteric fracture.

Methods: From March 2016 to August 2019, 127 patients with femoral intertrochanteric fractures who underwent proximal femoral nail antirotation(PFNA) were retrospectively analyzed. They were divided into two groups according to different methods of thrombus prevention and treatment. Read More

Clin Transplant 2022 Apr 25:e14688. Epub 2022 Apr 25.

Division of Abdominal Transplantation and Hepatobiliary Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA.

Background: Deep venous thrombosis (DVT) prophylaxis is often employed to prevent the potentially serious complication of pulmonary embolism (PE). However, little data exist regarding the optimal DVT prophylaxis strategy for living donors undergoing hepatectomy for living donor liver transplantation. Here we present our consensus statement on DVT prophylaxis for living donors undergoing hepatectomy. Read More

J Am Acad Orthop Surg Glob Res Rev 2022 04 1;6(4). Epub 2022 Apr 1.

From the Department of Orthopedic Surgery, Jersey City Medical Center-RWJBarnabas Health, Jersey City, NJ (Dr. Tang, Dr. Yoon, and Dr. Liporace), and the Department of Orthopedic Surgery, NYU Langone Health, New York, NY (Dr. Aggarwal, and Dr. Schwarzkopf).

Introduction: Obstructive sleep apnea (OSA) is a known risk factor for venous thromboembolism (VTE), defined as pulmonary embolism (PE) or deep vein thrombosis (DVT); however, little is known about its effect on VTE rates after total joint arthroplasty (TJA). This study sought to determine whether patients with OSA who undergo TJA are at greater risk for developing VTE versus those without OSA.

Methods: A retrospective analysis was conducted on 12,963 consecutive primary TJA patients at a single institution from 2016 to 2019. Read More

J Am Acad Orthop Surg 2022 07 18;30(13):e919-e928. Epub 2022 Apr 18.

From the Florida International University Herbert Wertheim College of Medicine, Miami, FL (Sheth, Ravipati, Arif, and Castro), the Department of Orthopaedic Surgery and Rehabilitation, Maimonides Medical Center, Brooklyn, NY (Sheth), and the Department of Orthopaedic Surgery, University of Miami, Miami, FL (Yakkanti and Hernandez).

Introduction: Postoperative venous thromboembolism (VTE) is a major risk for orthopaedic surgery and associated with notable morbidity and mortality. Knowing a patient's risk for VTE may help guide the choice of perioperative VTE prophylaxis. Recently, red blood cells (RBCs) have been implicated for their role in pathologic thrombosis. Read More

Neurosurgery 2022 Jul 7;91(1):115-122. Epub 2022 Apr 7.

Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Background: Venous thromboembolism (VTE), encompassing deep venous thrombosis (DVT) and pulmonary embolism (PE), causes postoperative morbidity and mortality in neurosurgical patients. The use of pharmacological prophylaxis for DVT prevention in the immediate postoperative period carries increased risk of intracranial hemorrhage, especially after skull base surgeries.

Objective: To investigate the impact of routine Doppler ultrasound monitoring in prevention and tiered management of VTE after skull base surgery. Read More

J Orthop Traumatol 2022 Mar 7;23(1):12. Epub 2022 Mar 7.

Department of Orthopedic Surgery, The Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Xuzhou, 221002, Jiangsu, People's Republic of China.

Background: It is still unknown whether tranexamic acid (TXA) is beneficial for the minimally invasive surgical approach to total hip arthroplasty (THA). The aim of this study is to investigate the efficacy and safety of intravenous TXA in primary THA via the direct anterior approach (DAA).

Materials And Methods: We performed a retrospective analysis of prospectively collected data on 70 patients with nontraumatic avascular necrosis of the femoral head who underwent THA via the DAA between October 2017 and October 2018. Read More

J Arthroplasty 2022 05 19;37(5):958-965.e3. Epub 2022 Jan 19.

Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH.

Background: Venous thromboembolism (VTE) is a potential postoperative complication after total hip arthroplasty (THA). These events present with a range of severity, and some require readmission. The present study aimed to identify unexplored risk factors for severe VTE that lead to hospital readmission. Read More

Vasc Specialist Int 2021 Dec 31;37:45. Epub 2021 Dec 31.

Department of General Surgery, Istanbul Medeniyet University, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey.

Purpose: The aim of this study is to evaluate the outcomes of pharmacological thromboprophylaxis given for short-term duration to the patients who underwent major abdominal surgery for colorectal and gastric cancer.

Materials And Methods: This retrospective cohort study was performed in consecutive patients who underwent major abdominal surgery for colorectal and gastric cancer and received short-term pharmacological thromboprophylaxis during hospital stay were enrolled. Complete duplex ultrasonography of the lower limbs was performed for all patients to investigate both symptomatic and asymptomatic deep vein thrombosis (DVT). Read More

Int Forum Allergy Rhinol 2022 Jul 5;12(7):935-941. Epub 2022 Jan 5.

Division of Rhinology/Endoscopic Skull Base Surgery, Department of Otolaryngology - Head & Neck Surgery, Stanford University School of Medicine, Stanford, CA.

Background: Venous thromboembolism (VTE) is a potentially fatal perioperative complication. The objective of this study was to assess the rate and risk factors for VTE in endoscopic skull base surgery (ESBS).

Methods: This was a retrospective review of adults undergoing ESBS at a tertiary academic center. Read More

Ann Med 2021 12;53(1):1816-1826

Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China.

Objective: Total knee replacement (TKA) is an effective way to treat teratogenic and disabling knee diseases such as advanced osteoarthritis. Tourniquets are often used in TKA to reduce bleeding and to get a better visualization of the surgical field, while it is related to safety concerns. We did this network meta-analysis to comprehensively compare the efficacy and safety of various tourniquet application strategies. Read More

Sci Rep 2021 10 28;11(1):21240. Epub 2021 Oct 28.

Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA.

The association between blood transfusions and thromboembolic events (VTE) following total joint arthroplasty (TJA) remains debatable. Using contemporary institutional data, this study aimed to determine whether blood transfusions increase the risk of VTE following primary and revision TJA. This was a single institution, retrospective cohort study. Read More

Surg Today 2022 Jun 25;52(6):904-913. Epub 2021 Oct 25.

Division of Gastrointestinal Surgery and Surgical Oncology, Graduate School of Medicine, Ehime University, Shitsukawa, Toon, Ehime, 791-0295, Japan.

Purpose: During the perioperative period, coagulofibrinolytic activation occurs, which occasionally results in thromboembolic complications. However, natural perioperative coagulofibrinolytic responses have not been well investigated. The present study examined perioperative coagulofibrinolytic changes and their association with the development of venous thromboembolism (VTE). Read More

Orthop Surg 2021 Dec 19;13(8):2227-2235. Epub 2021 Oct 19.

Department of Orthopaedics Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei, China.

Objective: To assess the efficacy and safety of postoperative intravenous tranexamic acid (TXA) in patients undergoing total knee arthroplasty (TKA).

Methods: From March 2020 to August 2020, all patients undergoing primary unilateral TKA in our hospital were considered in prospective randomized controlled study. Included patients were randomized into three groups to receive either two doses of 15 mg/kg intravenous TXA postoperatively, at 2 and 24 h after closing the incision (group A), or a single dose of 15 mg/kg intravenous TXA 2 h postoperatively (group B), or placebo (group C). Read More

J Vasc Surg Venous Lymphat Disord 2022 05 8;10(3):767-777.e3. Epub 2021 Sep 8.

Division of Hematology, Department of Medicine, Duke University, Durham, NC; Department of Pathology, Duke University, Durham, NC.

Background: Venous thromboembolism (VTE) is a well-known complication associated with surgical procedures. The implementation of thromboprophylaxis in this population has become a vital aspect of perioperative care to decrease VTE-associated morbidity and mortality risk. However, data assessing the role of thromboprophylaxis for patients undergoing vascular surgery are sparse. Read More

Clin Appl Thromb Hemost 2021 Jan-Dec;27:10760296211033024

Department of Orthopedic Trauma, Honghui Hospital, 12480Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China.

This study was to investigate the incidences of DVT in lower extremities after pelvic fracture before and after operation, and explore the risk factors. The records of patients with pelvic fractures receiving operation were collected. The patients were examined by preoperative and postoperative ultrasonography, and divided into thrombosis group and non-thrombosis group according to the preoperative and postoperative ultrasonographic results. Read More

Colorectal Dis 2021 Aug 29;23(8):1982-1988. Epub 2021 Jun 29.

Peritoneal Malignancy Institute, Basingstoke and North Hampshire Hospital, Basingstoke, UK.

Aims: Patients with abdominal cancer requiring major surgical intervention are at high risk of venous thromboembolic events (VTE), particularly pulmonary emboli (PE). A proportion of patients with cancer can present with, or have had, major VTEs prior to definitive surgical treatment. Preoperative percutaneous inferior venal caval filters (IVCF) may reduce the risk of PE. Read More

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2022 May 27;166(2):204-210. Epub 2021 May 27.

Deartment of Anesthesiology, Perioperative Medicine and Intensive Care Masaryk Hospital, J.E. Purkinje University, Usti nad Labem, Czech Republic.

Background: Deep vein thrombosis (DVT) is a serious but preventable complication of critical illness with a reported incidence from 4 to 17%. Anti-Xa activity in critically ill patients achieved with standard dosing of low-molecular-weight heparins (LMWH) is often below the target of 0.2-0. Read More

Medicine (Baltimore) 2021 May;100(18):e25639

Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University.

Background: Salvianolate, a common drug for stabilizing heart disease and Angina Pectoris, is considered to be off-label for preventing venous thromboembolism (VTE) or anticoagulation at present. However, many clinical studies have showed that salvianolate can effectively inhibit the deep-vein thrombosis (DVT) incidence, and prevent VTE of perioperative patients in the real world in China.

Objective: This analysis aimed to evaluate the effectiveness and safety of salvianolate in preventing VTE in perioperative patients. Read More

J Obstet Gynaecol Can 2022 Jan 18;44(1):82-96.e1. Epub 2021 Apr 18.

Hamilton, ON.

Objective: The primary objective of this clinical practice guideline is to provide gynaecologists with an algorithm and evidence to guide the use of thromboprophylaxis in gynaecological surgery.

Target Population: All patients undergoing gynaecological surgery for benign or malignant indications.

Benefits, Harms, And Costs: The implementation of this guideline will benefit patients undergoing gynaecological surgery and provide physicians with a standard algorithm for the use of perioperative thromboprophylaxis. Read More

Global Spine J 2021 Apr 20:2192568220979139. Epub 2021 Apr 20.

22683Baylor University Medical Center, Dallas, TX, USA.

Study Design: Systematic literature review.

Objectives: The impact of thromboembolic disease on the morbidity and mortality of patients with acute spinal cord injury is well documented, with rates as high as 67%-100% among untreated patients. The efficacy of mechanical prophylaxis as a stand-alone measure has been questioned, so we sought to determine a safe perioperative window for chemical anticoagulation use after spine surgery. Read More

Pediatr Transplant 2021 Jun 27;25(4):e14017. Epub 2021 Mar 27.

Department of Pediatrics, Section of Pediatric Gastroenterology and Hepatology, University of Chicago, Chicago, IL, USA.

Patients with cirrhotic liver disease are in a state of fluctuating hemostatic balance. Hepatic synthetic dysfunction is commonly complicated by coagulation disorders that constitute an important parameter of most prognostic scores. The dominant feature of this dysfunction is bleeding tendencies, but cirrhotic patients may also exhibit inappropriate clotting and pro-coagulation placing them at risk for thromboembolism. Read More

J Pediatr Surg 2021 Dec 13;56(12):2360-2363. Epub 2021 Feb 13.

Department of Surgery, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, United States; Department of Surgery, University of Tennessee Health Science Center, 910 Madison Ave, Memphis, TN 38163, United States; Division of Pediatric Surgery, LeBonheur Children's Hospital, 848 Adams Ave, Memphis, TN 38103, United States. Electronic address:

Purpose: Cancer is a well-established risk factor for deep venous thrombosis (DVT). We sought to assess the incidence of DVT in pediatric cancer patients undergoing select surgical procedures at our institution and to identify additional factors associated with DVT development.

Methods: We performed a retrospective review of cancer patients who underwent select surgical procedures and developed a DVT within 30 days of their operation from 2000 to 2018 at our institution. Read More

J Gastrointest Surg 2021 02 8;25(2):339-350. Epub 2021 Jan 8.

Department of Surgery, Division of Colorectal Surgery, City of Hope National Medical Center, 1500 E. Duarte Road, Suite MA, Duarte, CA, LP-2230, USA.

Perioperative management entails the multiple substeps in the performance of major abdominal surgery that are considered relevant for an optimal outcome. The PG/CME symposium of the SSAT 2018 provided a set of key talks that the authors subsequently summarized in the respective subsections of this summary article. Highlights topics included oral antibiotics and mechanical bowel prep, surgical site infections, DVT prophylaxis, enhanced recovery after surgery (ERAS), and narcotic-sparing pain management. Read More

Surg Today 2021 Jun 2;51(6):1022-1027. Epub 2021 Jan 2.

Department of Digestive and Transplant Surgery, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan.

Purpose: Venous thromboembolism (VTE) is a major complication after abdominal surgery; however, the best strategy for preventing VTE after surgery is not yet established. We performed this study to investigate the incidence of perioperative VTE and evaluate the efficacy of a VTE preventive strategy for patients undergoing surgery for colorectal cancer (CRC).

Methods: The subjects of this retrospective analysis were 228 patients who underwent curative surgical resection for CRC between 2012 and 2016. Read More

J Orthop Surg Res 2020 Dec 10;15(1):597. Epub 2020 Dec 10.

Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, 400000, China.

Objective: Clinical characteristics, anticoagulant protocols, and risk factors of deep vein thrombosis (DVT) in patients with femoral and pelvic fractures were analyzed throughout the perioperative period to provide references for early identification and optimization of risk factors.

Methods: This was a retrospective study. A total of 569 patients undergoing surgery of femoral and pelvic fractures from May 2018 to December 2019 were included. Read More