Venous Thromboembolism Prophylaxis For Esophagectomy: A Survey of Practice Patterns Among Thoracic Surgeons Brittany A. Zwischenberger, MD, Ching-Wei.

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Presentation transcript:

Venous Thromboembolism Prophylaxis For Esophagectomy: A Survey of Practice Patterns Among Thoracic Surgeons Brittany A. Zwischenberger, MD, Ching-Wei D. Tzeng, MD, Nicholas D. Ward, MD, Joseph B. Zwischenberger, MD, Jeremiah T. Martin, MBBCh FRCSI The Annals of Thoracic Surgery Volume 101, Issue 2, Pages 489-494 (February 2016) DOI: 10.1016/j.athoracsur.2015.07.023 Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Postoperative chemical venous thromboembolism prophylaxis used by surgeons. “Other” includes Fragmin (Pfizer, New York, NY), 5,000 units subcutaneous daily. The Annals of Thoracic Surgery 2016 101, 489-494DOI: (10.1016/j.athoracsur.2015.07.023) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Surgeon-estimated overall postoperative (within 30 days) risk of developing venous thromboembolism (VTE) for a patient undergoing an esophagectomy for any diagnosis. The American College of Chest Physicians describes VTE risk categories as very low (<0.5%), low risk (∼1.5%), moderate risk (∼3%), and high risk (∼6%). These are marked by vertical lines along the bar graph. The Annals of Thoracic Surgery 2016 101, 489-494DOI: (10.1016/j.athoracsur.2015.07.023) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Timing of initial chemical venous thromboembolism prophylaxis: Preoperatively includes within 24 hours of the operation, in preoperative holding, or before the incision; postoperative day (POD) 0 includes in the recovery room or during day of the operation. The Annals of Thoracic Surgery 2016 101, 489-494DOI: (10.1016/j.athoracsur.2015.07.023) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Postoperative venous thromboembolism (VTE) prophylaxis allowed by the pain team while the epidural is in place. Multiple answers were allowed. (LMWH = low-molecular-weight heparin [ie, enoxaparin]; SCD = sequential compression device.) The Annals of Thoracic Surgery 2016 101, 489-494DOI: (10.1016/j.athoracsur.2015.07.023) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions