Prevention of postoperative venous thrombosis in patients with low risk of venous thromboembolic complications

Introduction. Venous thromboembolic complications after elective surgical interventions are still an urgent problem, especially in low-risk patients. They require special research and analysis, which is the purpose of this work.

Aim. To study and evaluate the possibilities of a personalized approach to the prevention of acute venous thrombosis during elective surgery in patients at low risk of venous thromboembolic complications.

Materials and methods. 80 patients with common surgical pathology (chronic calculous cholecystitis, external abdominal hernias and varicose veins of the lower extremities) and identified as low-risk were divided into two groups. In accordance with current clinical recommendations, mechanical prophylaxis measures were used to prevent postoperative VTE in group 1 patients. In patients of group 2, taking into account the revealed hypercoagulation based on the thrombodynamics test, pharmacoprophylaxis using anticoagulants was added to the measures of mechanical prophylaxis. The plasma parameters of the hemostasis system were evaluated both before the planned surgical intervention and in the postoperative period on days 1–3, 7–9, 14–16 and 30. Ultrasound examination was performed to assess the condition of the venous system of the lower extremities and pelvis.

Results. It was revealed that in the preoperative period, according to the thrombodynamics test, 23.8% of patients showed initial hypercoagulation. In the postoperative period, the number of hypercoagulation cases increased to 31.3% due to group 1 patients who underwent only mechanical prophylaxis of VTE in the perioperative period. Deep vein thrombosis in the postoperative period was detected in 15% of patients and in all cases they developed in the presence of preoperative hypercoagulation.

Conclusions. The high informative value of the thrombodynamics test in the prediction and diagnosis of VTE during elective surgical interventions is shown.

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