Venous Thromboembolism after Thoracotomy and Lung LobectomyIn Patients with Lung Malignancy

Abstract: Background: Venous thromboembolism, manifesting as deep vein thrombosis (DVT) and pulmonary embolism (PE), is a significant source of morbidity and mortality and a cause of postoperative complications after invasive surgery. These adverse events are more likely to occur in high risk patients, such as those with cancer or undergoing major surgery with the highest incidence peak taking place within the first month after surgery. Despite the issue being globally recognized, a lack of consensus regarding guidelines for prophylaxis post-discharge still exists. Aim: To determine the incidence of venous thromboembolism within a 30-day postoperative period after thoracotomy and lung lobectomy for lung malignancy, to assess a correlation of the above with administered prophylactic treatment. Method: A retrospective cohort study was conducted as a review of medical records of all patients, appertaining to Örebro county, who had undergone thoracotomy and lung lobectomy for lung cancer or secondary malignant tumor in the lung, during 2015-2017 at the department of Cardiothoracic and Vascular Surgery, Örebro University Hospital. An internally validated register was used to identify the patient population and partial collection of the data. Results: Of the 67 included patients 50,8% were men and the mean age of the population was 67,5 years. The VTE prevalence during the 30-day postoperative period was 1,5%. A total of 59,7% of the patients received thrombosis prophylaxis preoperatively, 98,1% postoperatively and 11,9 % after hospital discharge. Conclusion: The VTE prevalence of 1,5% in this study may suggest the current postoperative prophylactic regiment successful, yet VTE remains a clinically significant complication, and the need for well-defined guidelines is evident.