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Meta-Analysis
. 2023 Oct 3;23(1):933.
doi: 10.1186/s12885-023-11424-x.

Risk of venous thromboembolism in patients undergoing gastric cancer surgery: a systematic review and meta-analysis

Lin Xiang  1   2 , Shuai Jin  3 , Yang Yu  4   5 , Dengfeng Wang  6 , Hao Chen  7   8   9
Affiliations
Meta-Analysis

Risk of venous thromboembolism in patients undergoing gastric cancer surgery: a systematic review and meta-analysis

Lin Xiang et al. BMC Cancer. .

Abstract

Background: Venous thromboembolism (VTE) is a common postoperative complication in patients undergoing surgery for gastric cancer (GC). Although VTE incidence may vary among cancers, guidelines rarely stratify preventive methods for postoperative VTE by cancer type. The risk of VTE in patients undergoing surgery for GC remains unclear.

Methods: A systematic review and meta-analysis was undertaken to determine the risk of VTE after GC surgery and discuss the clinical value of pharmacological thromboprophylaxis in these cases. Medline, Embase, Web of Science, and Cochrane Library databases were searched for articles published from their inception to September 2022.

Results: Overall, 13 studies (111,936 patients) were included. The overall 1-month incidence of VTE, deep vein thrombosis (DVT), and pulmonary embolism (PE) after GC surgery was 1.8% (95% CI, 0.8-3.1%; I²=98.5%), 1.2% (95% CI, 0.5-2.1%; I²=96.1%), and 0.4% (95% CI, 0.1-1.1%; I²=96.3%), respectively. The prevalence of postoperative VTE was comparable between Asian and Western populations (1.8% vs. 1.8%; P > 0.05). Compared with mechanical prophylaxis alone, mechanical plus pharmacological prophylaxis was associated with a significantly lower 1-month rate of postoperative VTE and DVT (0.6% vs. 2.9% and 0.6% vs. 2.8%, respectively; all P < 0.05), but not PE (P > 0.05). The 1-month postoperative incidence of VTE was not significantly different between laparoscopic and open surgery (1.8% vs. 4.3%, P > 0.05).

Conclusion: Patients undergoing GC surgery do not have a high risk of VTE. The incidence of VTE after GC surgery is not significantly different between Eastern and Western patients. Mechanical plus pharmacological prophylaxis is more effective than mechanical prophylaxis alone in postoperative VTE prevention. The VTE risk is comparable between open and laparoscopic surgery for GC.

Keywords: Gastric cancer surgery; Incidence; Venous thromboembolism.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
PRISMA flow chart showing article selection process
Fig. 2
Fig. 2
Forest plots of postoperative VTE, DVT, and PE within 1 month in GC
Fig. 3
Fig. 3
Forest plots of postoperative VTE, DVT, and PE within 7 days in GC
See this image and copyright information in PMC

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