Elevation in D-Dimer Levels after the Surgical Treatment of Stage IA Extramammary Paget’s Disease: A Risk of Deep Vein Thrombosis

Background:D-dimer levels have been well studied among patients undergoing total hip replacement to measure the risk of deep vein thrombosis (DVT). However, no study has been conducted on the rate of DVT development in patients undergoing skin surgery.Objective:To retrospectively review the postoperative frequency of DVT development and D-dimer levels in patients undergoing skin surgery.Methods & Materials:For analyzing patients with the same disease and the same affected anatomical region, we enrolled 12 patients with stage IA extramammary Paget's disease who were surgically treated in Kurume University Hospital between 2011 and 2014.We analyzed the postoperative rate of DVT development and changes in plasma D-dimer levels.Results:No patient developed postoperative symptomatic DVT, but D-dimer levels were elevated in all patients postoperatively.The mean ± SD maximum D-dimer level was 4.1 ± 2.7 μg/ml (normal, ≤1.0 μg/ml).The mean ± SD postoperative day when the maximum D-dimer level was reached was 10.6 ± 4.9 days.Older patients (≥75 years) tended to have higher maximum D-dimer levels than younger patients (<75 years).Conclusion:Although elevated D-dimer levels may not be associated with DVT in this context, further studies may disclose a cutoff level for predicting DVT in patients undergoing skin surgery.