Preoperative D-dimer as a predictor of venous thromboembolism after laparoscopic gastric and colorectal cancer surgery: findings from the EnoLap trial.

PURPOSE: Venous thromboembolism (VTE) is a potentially serious complication after surgery for gastrointestinal cancer; however, its risk factors following laparoscopic surgery remain unclear. This study aimed to identify the risk factors for postoperative VTE in patients undergoing laparoscopic gastrectomy or colectomy.

METHODS: We analyzed data, retrospectively, from patients enrolled in the multicenter randomized EnoLap-CG trial, who underwent laparoscopic gastrectomy or colectomy. All patients underwent protocol-mandated contrast-enhanced computed tomography (CT) on postoperative day (POD) 7 to screen for VTE.

RESULTS: Postoperative VTE was identified in 19 (4.6%) of 410 patients. The preoperative D-dimer level was significantly higher in the VTE group than in the no- VTE group (1.40 µg/mL vs. 0.76 µg/mL; p < 0.01). The incidence of VTE was higher in women than in men (7.2% vs. 2.9%; p = 0.05). Multivariate logistic regression analysis demonstrated that an elevated preoperative D-dimer level (OR, 1.89; 95% CI, 1.28-2.80; p < 0.01) and female sex (OR, 2.64; 95% CI, 1.02-6.85; p < 0.01) were independent risk factors for VTE.

CONCLUSIONS: An elevated preoperative D-dimer level and female sex are independent risk factors for postoperative VTE after laparoscopic gastric and colorectal cancer surgery.