Analysis Of Risk Factors Of Lower Extremity Deep Venous Thrombosis After Laparoscopic Colorectal Cancer Surgery

Objective: To explore the risk factors of lower extremity deep venous thrombosis(LDVT)after laparoscopic colorectal cancer surgery,and provide clinical ideas and theoretical basis for the prevention and treatment of LDVT after colorectal cancer surgery.Methods: Select 154 patients with colorectal cancer who underwent laparoscopic radical resection of colorectal cancer from January 2021 to January 2022 in the Department of Gastroenterology,Affiliated Hospital of Southwest Medical University.Four patients were excluded according to the exclusion criteria,and finally 150 patients were included.According to whether the patients had LDVT within 2 weeks after operation,they were divided into thrombotic group(41 cases)and non-thrombotic group(109 cases).Gender,age,body mass index(BMI),white blood cell(WBC)Neutrophils/lymphocytes(NLR),platelets(PLT),prothrombin time(PT),partially activated prothrombin time(APTT),fibrinogen(FIB),D-dimer(D-D),operation time,intraoperative blood loss,combined basic diseases(hypertension,diabetes,coronary heart disease),postoperative complications(infection,anastomotic fistula),bed rest time,tumor staging and typing,depth of invasion,lymph node metastasis,degree of differentiation,perineural invasion(PNI),Lypho-vascular invasion(LVI),The risk factors that may affect the formation of LDVT after laparoscopic radical resection of colorectal cancer were analyzed.SPSS20.0 statistical analysis data was used to test the normality of the measurement data.The continuous numerical variables satisfying the normal distribution were expressed in x ± s,the counting data between the two groups were compared by Chi-square test or Fisher exact probability method,the measurement data were compared by independent sample t-test,and the Mann-Whitney U test was used to compare the two groups of numerical variables of the non-normal distribution,and the data were expressed in M(Q1,Q3);Then the statistically significant risk factors were analyzed by multivariate logistic regression analysis,and the final significant indicators were determined as the independent risk factors of LDVT formation.Results: Among the 150 patients included in this study,41 had LDVT,with an incidence of 27.3%.There were 23(15.3%)males and18(12%)females,aged 43-84 years,with an average age of 68.32 ±9.92 years.Among the 41 patients with thrombus,the distribution of thrombus was as follows: 12 cases(29.3%)in the right lower limb,13cases(31.7%)in the left lower limb,16 cases(39.0%)in both lower limbs,and no patients with pulmonary embolism;Specifically,there were 3 cases of right peroneal vein(7.3%),2 cases of right femoral vein(4.9%),1 case of right posterior tibial vein(2.4%),3 cases of left peroneal vein(7.3%),2 cases of bilateral peroneal vein(4.9%),and 30 cases of intermuscular vein(73.2%);The results of univariate analysis showed that age ≥ 63 years old(P<0.001),operation time ≥ 4 hours(P=0.042),postoperative bedtime ≥ 3 days(P=0.002),preoperative complications(P=0.001),postoperative complications(P<0.001),WBC(P=0.010),D-D(P=0.001),vascular invasion(P=0.027)were risk factors for the formation of LDVT after laparoscopic colorectal cancer surgery.Multivariate binary logistic regression analysis showed that age ≥ 63 years old(P=0.040),OR=2.823,95% CI1.0477.616),preoperative complications(P=0.010,OR=3.561,95% CI1.3489.406),postoperative complications(P=0.001,OR=8.739,95%CI 2.498-30.575),D-D(P=0.035,OR=1.185,95% CI 1.012-1.387)were independent risk factors for the formation of LDVT.Conclusions: 1.The formation of LDVT in patients after laparoscopic colorectal cancer is mainly interintramuscular vein thrombosis;2.Univariate analysis showed that age ≥ 63 years,postoperative bed rest time ≥ 3 days,preoperative complications(hypertension,diabetes,coronary heart disease),postoperative complications(infection,anastomotic fistula),WBC,D-D,vascular invasion are risk factors for LDVT formation in patients after laparoscopic colorectal cancer surgery.3.Multifactor binary logistic regression analysis showed that age ≥ 63 years old,preoperative basic diseases(hypertension,diabetes,coronary heart disease),postoperative complications(infection,anastomotic fistula),and D-D are independent risk factors for the formation of LDVT after laparoscopic colorectal cancer surgery.