Clinical Characteristics And Risk Factors Ofdeep Venous Thrombosis Of Lower Extremities In Perioperatiive Gastric Cancer Patients

Objectives:To detect the clinical characteristics and the risk factors for deep venous thrombosis(DVT)during perioperative period in patients with gastric cancer in patients? Methods:Clinical data were collected from 167 patients with gastric cancer admitted to Gastrointestinal Surgery Department of our hospital from February 2015 to September 2016,and those patients failing the inclusion criteria were excluded from the study.Patients were assigned,depending on the presence or absence of venous thrombosis of lower extremities,to the thrombosis group or non-thrombosis group.The factors that may have impact on the development of perioperative DVT of lower extremities in gastric cancer,e.g.,age,sex,length of hospital stay,body mass index(BMI),smoking,alcohol intake,surgical approach,surgery duration,postoperative use of hemostatics,postoperative infection or suture fistula,hypertension,and diabetes mellitus,were subject to risk factor analysis,and a model was established to predict the perioperative risk level of gastric cancer.C hi-square test was used for univariate analysis,and binary multivariate Logistic regression was used for multivariate analysis,where P<0.05 would indicate a statistically significant difference.Results:Among the 167 patients with gastric cancer admitted to our hospital from February 2015 to September 2016,3 were excluded from the study due to incomplete clinical data or other reasons,and 164 were included in the study.Among the 164 included patients,the incidence of DVT of lower extremities was 13.8%(23/164).Among the 23 patients with DVT of lower extremities,14(60.9%)were males and 9(39.1%)were females;the age was 27-82 years,with the mean 59.8±4.9 years;19(82.6%)were asymptomatic and 4(17.4%)were symptomatic,and none of patients reported symptoms of pulmonary embolism;the thrombosis developed in the left lower extremity in 10(43.4%%)patients,in the right lower extremity in 6(26.1%)patients,and in both lower extremities in 7(30.4%)patients;the most commonly affected veins were calf muscular vein in 19(82.6%)patients,peroneal vein in 3(13.0%)patients,and posterior tibial vein in 1(4.3%)patients.Following univariate analysis and excluding the confounding factors,binary multivariate regression analysis identified age?60 years,BMI ?25 kg/m2,hypertension(P<0.001),postoperative complications(postoperative infection and suture fistula),surgery duration>3.5h,and postoperative use of hemostatics as the independent perioperative risk factors for DVT of lower extremities in gastric cancer.Analysis on the risk level prediction model showed that the incidence of DVT was0 in the absence of any risk factor,4.76% in the presence of 1 risk factor,27.8% in the presence of 2 risk factors,and 43.75% in the presence of ?3 risk factors.Conclusion:1.The incidence of perioperative DVT of lower extremities is high in gast ric cancer,which is primarily asymptomatic calf muscular vein thrombosis and more likely to affect the left lower extremity than the right lower extremity.2.Age?60 years,hypertension,postoperative complications(postoperative infection and suture fistula),postoperative use of hemostatics,BMI ?25 kg/m2,and surgery duration>3.5h,etc.,are the independent perioperative risk factors for DVT of lower extremities in gastric cancer.3.For perioperative patients with gastric cancer at intermediate or high risk of DVT of lower extremities,early diagnosis and prevention could reduce the incidence of DVT of lower extremities.