학술논문
A Propensity-Matched Analysis of the Postoperative Venous Thromboembolism Rate After Pancreatoduodenectomy Based on Operative Approach.
Document Type
Academic Journal
Author
Hue JJ; Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, 11000 Euclid Avenue, Lakeside 7013, Cleveland, OH, 44106, USA.; Elshami M; Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, 11000 Euclid Avenue, Lakeside 7013, Cleveland, OH, 44106, USA.; Beckman MJ; Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, Atrium Health, Charlotte, NC, USA.; Driedger MR; Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, Atrium Health, Charlotte, NC, USA.; Rothermel LD; Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, 11000 Euclid Avenue, Lakeside 7013, Cleveland, OH, 44106, USA.; Hardacre JM; Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, 11000 Euclid Avenue, Lakeside 7013, Cleveland, OH, 44106, USA.; Ammori JB; Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, 11000 Euclid Avenue, Lakeside 7013, Cleveland, OH, 44106, USA.; Winter JM; Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, 11000 Euclid Avenue, Lakeside 7013, Cleveland, OH, 44106, USA.; Ocuin LM; Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, 11000 Euclid Avenue, Lakeside 7013, Cleveland, OH, 44106, USA. lee.ocuin@UHhospitals.org.
Source
Publisher: Springer Country of Publication: United States NLM ID: 9706084 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-4626 (Electronic) Linking ISSN: 1091255X NLM ISO Abbreviation: J Gastrointest Surg Subsets: MEDLINE
Subject
Language
English
Abstract
Background: The use of minimally invasive approaches for pancreatoduodenectomy has increased in recent years, but the risk of postoperative VTE is undefined. We aimed to compare venous thromboembolism (VTE) rates after open and minimally invasive pancreatoduodenectomy using an administrative dataset.
Methods: Patients who underwent pancreatoduodenectomy within the National Surgical Quality Improvement Program targeted pancreatectomy database (2016-2018) were identified. VTE was compared between patients who underwent open or minimally invasive pancreatoduodenectomy directly and after propensity score matching 1:1 for demographics, comorbidities, and peri-/intra-operative factors.
Results: A total of 12,227 patients underwent pancreatoduodenectomy during the study period (open: n = 11,217; minimally invasive: n = 1010). Before matching, the VTE rate was higher among patients who underwent minimally invasive pancreatoduodenectomy (5.2% vs. 3.8%, p = 0.033), and minimally invasive resection was independently associated with VTE (OR = 1.46, 95%CI = 1.09-2.06). After matching, there were 916 patients per group without differences in demographics or comorbidities. Patients who underwent minimally invasive pancreatoduodenectomy had longer median operative times (422 vs. 348 min). The VTE rate remained higher following minimally invasive pancreatoduodenectomy after matching (5.1% vs. 2.9%, p = 0.018), mainly driven by a higher DVT rate (3.9% vs. 1.7%, p = 0.005).
Conclusions: Minimally invasive pancreatoduodenectomy is associated with a higher postoperative VTE rate compared to open pancreatoduodenectomy.
(© 2021. The Society for Surgery of the Alimentary Tract.)
Methods: Patients who underwent pancreatoduodenectomy within the National Surgical Quality Improvement Program targeted pancreatectomy database (2016-2018) were identified. VTE was compared between patients who underwent open or minimally invasive pancreatoduodenectomy directly and after propensity score matching 1:1 for demographics, comorbidities, and peri-/intra-operative factors.
Results: A total of 12,227 patients underwent pancreatoduodenectomy during the study period (open: n = 11,217; minimally invasive: n = 1010). Before matching, the VTE rate was higher among patients who underwent minimally invasive pancreatoduodenectomy (5.2% vs. 3.8%, p = 0.033), and minimally invasive resection was independently associated with VTE (OR = 1.46, 95%CI = 1.09-2.06). After matching, there were 916 patients per group without differences in demographics or comorbidities. Patients who underwent minimally invasive pancreatoduodenectomy had longer median operative times (422 vs. 348 min). The VTE rate remained higher following minimally invasive pancreatoduodenectomy after matching (5.1% vs. 2.9%, p = 0.018), mainly driven by a higher DVT rate (3.9% vs. 1.7%, p = 0.005).
Conclusions: Minimally invasive pancreatoduodenectomy is associated with a higher postoperative VTE rate compared to open pancreatoduodenectomy.
(© 2021. The Society for Surgery of the Alimentary Tract.)