Category: Clinical Oncology: Outcomes & Complications

MP21-21 - Preoperative D-dimer test as the screening of deep venous thrombosis in patients undergoing endourological surgery.

Sat, Sep 22
2:00 PM - 4:00 PM

Introduction & Objective : Deep venous thrombosis (DVT) is one of the serious postoperative complications of surgery. However, little is known about the presence of DVT before endourological surgery. The aim of this study was to investigate the usefulness of D-dimer test as the screening of DVT in patients undergoing endourological surgery.


Methods : From May 2015 to December 2017, 320 patients admitted to our hospital for endourological surgery were eligible for the retrospective study. All patients were examined preoperative D-dimer test. Subsequently, patients with high levels of D-dimer (≥1.0 μg/mL) were examined by ultrasonography of lower limbs. Age, sex, BMI, performance status, presence of malignancy, usage of steroid and preoperative serum levels of D-dimer were analyzed as a predictive factors of DVT.


Results : Among the 320 patients, 240 underwent laparoscopic surgeries, 44 underwent robotic surgeries and 36 underwent transurethral surgeries. Preoperative high levels of D-dimer were shown in 81 cases (25.3%). Preoperative DVT were detected in 20 (6.3%) patients overall. Positive predictive value was 24.7% (20/81). With regard to malignancy, there were 210 cases of malignant disease, 53 cases of adrenal tumors and 57 healthy kidney donors. Preoperative DVT were detected in 16 (7.6%) cases of malignant disease, 3 (5.7%) cases of adrenal tumors and 1 (1.8%) case of kidney donor. D-dimer levels were significantly higher in the patient detected DVT than the other patient (2.2 vs. 1.4 μg/mL, p = 0.017), however we found no significant relationships between other clinical parameters and preoperative DVT.


Conclusions : The preoperative combination of D-dimer test and ultrasonograpy appears to be useful in the preoperative diagnosis of DVT. 

Shuichi Tatarano

Assistant professor
Department of Urology, Kagoshima University
Kagoshima, Kagoshima, Japan

Shuichi Tatarano, M.D., Ph.D.
Associate professor, Department of Urology, Kagoshima University

Hideki Enokida

Kagoshima University
Kagoshima, Kagoshima, Japan

Masaya Yonemori

resident
Kagoshima University
Kagoshima, Kagoshima, Japan

Yasutoshi Yamada


Kagoshima, Kagoshima, Japan

Masayuki Nakagawa

Kagoshima University
Kagoshima, Kagoshima, Japan