Incidence of upper extremity deep vein thrombosis in the retrosternal reconstruction after esophagectomy

• Published in: BMC surgery 2022-03, Vol.22 (1), p.91-91, Article 91
• Main Authors: Yamada, Leo, Saito, Motonobu, Suzuki, Hiroya, Mochizuki, Shotaro, Endo, Eisei, Kase, Koji, Ito, Misato, Nakano, Hiroshi, Yamauchi, Naoto, Matsumoto, Takuro, Kaneta, Akinao, Kanke, Yasuyuki, Onozawa, Hisashi, Hanayama, Hiroyuki, Okayama, Hirokazu, Fujita, Shotaro, Sakamoto, Wataru, Watanabe, Yohei, Hayase, Suguru, Saze, Zenichiro, Momma, Tomoyuki, Ohki, Shinji, Kono, Koji
• Format: Article
• Language: English
• Subjects: Anticoagulants; Anticoagulants (Medicine); Central venous catheter; Esophagectomy; Esophagectomy - adverse effects; Heparin, Low-Molecular-Weight; Humans; Incidence; Medical research; Medicine, Experimental; Retrosternal reconstruction; Risk Factors; Thromboprophylaxis; Upper Extremity; Upper extremity deep vein thrombosis; Upper Extremity Deep Vein Thrombosis - drug therapy; Upper Extremity Deep Vein Thrombosis - epidemiology; Upper Extremity Deep Vein Thrombosis - etiology; Venous Thromboembolism - complications; Venous Thromboembolism - drug therapy
• ISSN: 1471-2482; 1471-2482
• DOI: 10.1186/s12893-022-01544-9

Upper extremity deep vein thrombosis (UEDVT) is relatively rare but cannot be negligible because it can cause fatal complications. Although it is reported that the occurrence rate of UEDVT has increased due to central venous catheter (CVC), cancer, and surgical invasion, there is still limited information for esophagectomy. The aim of this study was to evaluate the clinical factors, including CVC placement and thromboprophylaxis approach, as well as retrosternal space's width as a predictive factor for UEDVT in patients receiving esophagectomy. This study included 66 patients who underwent esophagectomy with retrosternal reconstruction using a gastric tube. All patients routinely underwent contrast-enhanced computed tomography (CT) on the 4th postoperative day. Low-molecular-weight-heparin (LMWH) was routinely administered by the 2nd postoperative day. To evaluate retrosternal space's width, (a) The distance from sternum to brachiocephalic artery and (b) the distance from sternum to vertebra were measured by preoperative CT, and the ratio of (a) to (b) was defined as the width of retrosternal space. Among all patients, 11 (16.7%) suffered from UEDVT, and none was preoperatively received CVC placement, while 7 were inserted in non-UEDVT cases. Retrosternal space's width in patients with UEDVT was significantly smaller than that in patients without UEDVT (0.17 vs. 0.26; P