Международный журнал физической медицины и реабилитации
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Incidence, Diagnosis, and Risk Factors of Venous Thromboembolism after Surgery for Malignant Bone and Soft Tissue Tumor of Lower Extremity

Yasuo Yoshimura, Shota Ikegami, Kaoru Aoki, Ken-ichi Isobe, Munehisa Kito, Kenji Kawasaki, Nau Ishimine, Jun-ichi Kurata, Mitsutoshi Sugano and Hiroyuki Kato

Objective: This study aimed to prospectively evaluate the incidence, characteristics, and risk factors of venous thromboembolism (VTE) development, and the diagnostic value of blood coagulation markers in patients receiving surgery for malignant bone and soft tissue tumor of lower extremity.

Methods: A prospective study of 20 patients who were examined using ultrasonography. Serum soluble fibrin monomer complex (SFMC) and D-dimer were measured in the perioperative period. VTE incidence, VTE development time, change in blood coagulation markers, and effect of each risk factor were evaluated.

Results: VTE was found in 8 of 20 patients. Four of these 8 patients had the finding of pulmonary embolism (PE) without symptom. Onset time of VTE was from day 1 to 7 after surgery. The cutoff value of SFMC was <3 μg/mL at any measurement point and D-dimer was approximately 2 g/mL in receiver operating characteristic analysis. Body mass index was the only significant risk factor.

Conclusion: VTE showed high incidence and often occurred in the early period in only physical prophylaxis after surgery. SFMC or D-dimer was not always useful to detect VTE development. With regard to rehabilitation intervention, risk management is required until 1 week after surgery.