Prophylaxis for Deep Vein Thrombosis and Pulmonary Embolism after Digestive Surgery using Intermittent Pneumatic Compression

Takashi Tsuji, Terumitsu Sawai, Hiroko Hayashi, Yoshihisa Yamada, Hirofumi Matsumoto, Takurou Miyazaki, Yukio Inamura, Tatsuya Nagasaki, Tohru Nakagoe and Hiroyoshi Ayabe

First Department of Surgery, Nagasaki University School of Medicine

Postoperative pulmonary embolism (PE) is a serious complication that has a high mortality rate. The majority of emboli are derived from deep vein thrombosis (DVT). Because the incidence of postoperative DVT and PE in Japan is low, prophylaxis for DVT and PE is not a common procedure. We have assessed the risk of DVT and PE using a preoperative original risk score system, and adapted Intermittent Pneumatic Compression (IPC) for all surgical patients since Dec. 1998. We compared the frequency of postoperative DVT and PE between the109patients treated without IPC who were operated on between August1997and November 1998 (non-IPC group) and the216patients treated with IPC who were operated on between December 1998 and March 2001 (IPC group). In the non-IPC group, four patients suffered from DVT or PE (3.7%), while only one patient experienced a PE attack in the IPC group (0.5%). This difference was statistically significant (p=0.045, Fisher's exact test). Logistic analysis revealed that IPC decreased the risk of DVT or PE tenth. No side effects of IPC were experienced. As two patients with mean or low risk scores developed DVT or PE, it was difficult to predict the occurrence of DVT and PE. IPC is an effective prophylaxis for DVT and PE and is both safe and easy to perform. Thus, IPC should be performed in all opertive patients.

Key words
pulmonary embolism, deep vein thrombosis, prophylaxis, intermittent pneumatic compression

Reprint requests
Takashi Tsuji First Department of Surgery, Nagasaki University School of Medicine 1-7-1 Sakamoto-machi, Nagasaki City, 852-8501 JAPAN

Accepted
October 31, 2001

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