Silent venous thromboembolism (VTE) in patients undergoing thoracic surgery in the course of lung cancer

Abstract

<b>Background:</b> Venous thromboembolism often occurs after thoracic surgery but can even occur before surgery in patients with lung cancer. <b>Aims:</b> The aim of the study was the investigation of the incidence of silent deep vein thrombosis (DVT) and pulmonary embolism (PE), confirmed by objective imaging tests, before and after thoracic surgery in the course of lung cancer. <b>Methods:</b> Venous ultrasound (US) imaging was performed to detect DVT before and after thoracic surgery in patients with non-small cell lung cancer. Plasma D-dimer (DD) levels as well as Caprini and Khorana risk scores were examined in all patients. All cases with signs or symptoms of PE after surgery were examined by computed tomography pulmonary angiography (CTPA). <b>Results:</b> The study was perfomed in 200 patients (M:K = 122:88) with lung cancer and hospitalized for thoracic surgery. All patients received primary antithromobotic prophylaxis by low molecular weight heparins. DVT was detected by US in 3 patients before thoracic surgery. There was no symptoms od DVT and DD Level was elevated in one case. PE was diagnosed by CTPA in 2 patients after surgery; there was no DVT in these cases. DD levels were elevated in both cases. <b>Conclusions:</b> Silent or subclinical VTE may occur before surgical treatment in many patients with non-small lung cell cancer. Risk factors for VTE as well as elevated DD level before treatment might not be sufficient for identification silent DVT in thoracic surgery. PE represent potentially lethal postoperative complication despite pharmacological prevention of VTE.