Examination of the effectiveness of perioperative venous thromboembolism prevention according to in-house guidelines in lung cancer surgery

Purpose: In-hospital venous thromboembolism (VTE) prevention guidelines were established in February 2019 at Kindai University Hospital. This study examined the effectiveness of postoperative pulmonary embolism prevention in cases in which perioperative management was performed in accordance with this guideline. Methods: A total of 740 patients were enrolled in this study. The patients underwent lung cancer surgery based on the new guidelines between July 2019 and August 2023. The control subjects were 944 patients who underwent lung cancer surgery between January 2013 and December 2018. Results: In this study, the prevalence of reduced resections, such as wedge resection and segmentectomy and of thoracoscopic surgery was higher compared to that in the control group. Thirty-three patients (4.5%) were diagnosed with deep venous thrombosis preoperatively, and this was lower than in the control group. Perioperative VTE risk assessment according to the hospital guidelines included four patients of moderate risk, 681 patients of high risk, and 55 patients of highest risk. Of the 55 highest risk patients, 13 patients received perioperative anticoagulant therapy. In the control group, one patient with pulmonary embolism was observed, but no postoperative pulmonary embolism was observed in the study group. Conclusion: No postoperative pulmonary embolism occurred in patients with lung cancer who underwent perioperative VTE prophylaxis in accordance with our hospital guidelines. VTE prophylaxis in accordance with the guidelines was considered appropriate.