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.