초록접수 현황
| 16F-080 | 구연 발표 |
Factors Associated with Incidentally found Stump Thrombosis after Lung Cancer Surgery: Can Postoperative Antiplatelet Therapy Reduce the Incidence of Stump Thrombosis after Primary Lung Cancer Surgery?
Mi Hyoung Moon, Hang Jun Choi, Young Kyu Moon, Jae Kil Park, Sook Whan Sung
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, The Catholic University College of Medicine, Seoul, Korea
Background : Current venous thromboembolic prophylaxis guideline recommends low molecular weight heparin administration, depending on the bleeding risk for each patients. Delayed postoperative thromboembolic event happens despite adherence to current prophylaxis guideline, and can be problematic.
Methods : We retrospectively reviewed patient records and CT findings for the primary lung cancer patients who received surgery between 2010 Jul to 2015 Aug. Postoperative chest computed tomography scan was routinely checked 3, 6, 12 months after surgery first year, then 6 months afterwards. There are two strategies for preventing pulmonary thromboembolism, one is routine administration of dual antiplatelet agents for 3 months after surgery, and the other one is single antiplatelet therapy for only the patients with neoadjuvant therapy. We analyzed factors associated with stump thrombosis.
Results : The incidence of incidentally found stump thrombosis was 3.72 %( 22/569 pts). Mean timing of stump thrombosis was 8.6 ± 11.3 month postoperatively. Stratified with neoadjuvant therapy, multivariate proportional Cox hazard model revealed thoracotomy conversion increased risk (HR 5.63, 95% CI 1.52 ~ 20.86) compared to either thoracotomy or VATS approach. Most powerful risk factor was age at operation (HR 1.11, 95% CI 1.04 ~ 1.19). Postoperative aspirin administration showed some protective tendency for stump thrombosis (HR 0.411, 95% CI 0.16 – 1.03), but statistical significance was limited.
Conclusion : Routine antiplatelet therapy showed some trends for decreasing the incidence of stump thrombosis after primary lung cancer surgery. Further investigation is warranted for clarifying the role of antiplatelet therapy, because of small numbers of patients in this study.
Methods : We retrospectively reviewed patient records and CT findings for the primary lung cancer patients who received surgery between 2010 Jul to 2015 Aug. Postoperative chest computed tomography scan was routinely checked 3, 6, 12 months after surgery first year, then 6 months afterwards. There are two strategies for preventing pulmonary thromboembolism, one is routine administration of dual antiplatelet agents for 3 months after surgery, and the other one is single antiplatelet therapy for only the patients with neoadjuvant therapy. We analyzed factors associated with stump thrombosis.
Results : The incidence of incidentally found stump thrombosis was 3.72 %( 22/569 pts). Mean timing of stump thrombosis was 8.6 ± 11.3 month postoperatively. Stratified with neoadjuvant therapy, multivariate proportional Cox hazard model revealed thoracotomy conversion increased risk (HR 5.63, 95% CI 1.52 ~ 20.86) compared to either thoracotomy or VATS approach. Most powerful risk factor was age at operation (HR 1.11, 95% CI 1.04 ~ 1.19). Postoperative aspirin administration showed some protective tendency for stump thrombosis (HR 0.411, 95% CI 0.16 – 1.03), but statistical significance was limited.
Conclusion : Routine antiplatelet therapy showed some trends for decreasing the incidence of stump thrombosis after primary lung cancer surgery. Further investigation is warranted for clarifying the role of antiplatelet therapy, because of small numbers of patients in this study.
책임저자: Sook Whan Sung
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, The Catholic University College of Medicine, Seoul, Korea
발표자: Mi Hyoung Moon, E-mail : sophiamoon@hanmail.net