Deep Venous Thromboembolism Following Ambulatory General Surgery.

Abstract

BackgroundVenous thromboembolism (VTE) is a well-established risk of inpatient surgery, but VTEs among ambulatory surgical patients are comparatively understudied.MethodsThis review assesses VTE risk after outpatient general surgeries. PubMed and Embase were queried for studies mentioning deep venous thrombosis or pulmonary embolism (PE) and outpatient or ambulatory surgery published between January 2000 and February 2022. Results were restricted to peer-reviewed English articles reporting postoperative VTE incidence or risk factors in adults undergoing elective, outpatient general surgery. Bariatric, oncologic, orthopedic, vascular, and plastic surgeries were excluded.ResultsA total of 678 unique articles were retrieved from PubMed (n = 198) and Embase (n = 480) with 12 articles meeting inclusion and exclusion criteria. Of the articles included, 3 articles focused on cholecystectomy and 2 on hernia repair. Reported risk factors for VTE included older age, higher BMI, prolonged operative duration, Trendelenburg positioning, and pneumoperitoneum. Reported postoperative VTE/PE incidence ranged from 0.0% to 0.5% regardless of procedure, comparable to the baseline annual VTE incidence in the general population.DiscussionThis study is the first review of recent literature on outpatient surgery VTEs. Limitations included patients presenting to different facilities for VTE evaluation, no standardized definition for ambulatory surgery, and short follow-up periods. Whether VTE/PE prophylaxis benefit outweighs associated risks should be addressed in future research.