Perioperative anticoagulation reduces the incidence of venous thromboembolism in patients undergoing gastrointestinal surgery.

Abstract

Background: The risk and mortality rate of venous thromboembolism (VTE) following gastrointestinal surgery remain high, and the symptoms are atypical. Therefore, it is necessary to identify the risk factors associated with the occurrence of VTE following gastrointestinal surgery and to implement appropriate prevention and treatment measures.

Aim: To assess the efficacy of perioperative anticoagulation for the prevention of postoperative VTE.

Methods: This retrospective study enrolled 205 patients who underwent gastrointestinal surgery. In the observation group (n = 101), prophylactic anticoagulation was administered via hypodermic injection of low-molecular-weight heparin during the perioperative period, whereas the control group (n = 104) only received low-molecular-weight heparin treatment postoperatively. Blood coagulation parameters and the incidence of VTE of the bilateral lower limbs pre- and post-surgery were compared between groups. Postoperative VTE was transformed into a dichotomous variable, and influencing factors were explored using multivariate logistic regression analyses.

Results: On the 7^th day postoperatively, the incidence of VTE of the bilateral lower limbs was significantly lower in the observation group than in the control group, as were the D-dimer levels (P < 0.05). At 1 month postoperatively, the incidence of VTE was significantly lower in the observation group than in the control group (P < 0.05). An age ≥ 65 years, a body mass index ≥ 24 kg/m², and malignant diseases of the digestive system were identified as risk factors for the occurrence of postoperative VTE in patients undergoing gastrointestinal surgery.

Conclusion: The incidence of VTE in patients who underwent gastrointestinal surgery peaked within 1 week postoperatively. The findings confirmed perioperative anticoagulation can safely and effectively reduce the incidence of postoperative VTE.