Key result
Prophylactic IVC clipping linked to a 0% rate of postoperative recurrent PE in colon surgery.
Why the study?
Prophylactic inferior vena cava clipping has been used to prevent postoperative pulmonary embolism in high-risk patients undergoing colonic surgery, but its safety and efficacy require evaluation.
Does prophylactic inferior vena cava clipping prevent postoperative pulmonary embolism in patients undergoing colonic operations?
Observational (n=30)
Does prophylactic inferior vena cava clipping prevent postoperative pulmonary embolism in patients undergoing colonic operations?
Prophylactic inferior vena cava clipping during colonic surgery appears safe and effective for preventing postoperative pulmonary embolism in high-risk patients.
May support selective IVCC in high-risk colonic surgery; leaves open need for randomized confirmation of efficacy and cost-effectiveness.
Incidental prophylactic inferior vena cava clipping (IVCC) has been used in 30 patients undergoing colonic operations. The results obtained compare quite favorably with other methods of preventing postoperative pulmonary embolism (PE). This procedure would be justified in patients with a postoperative PE risk greater than 5 to 10 per cent. Practical criteria to identify this group of patients are presented, and the value of utilizing a risk profile is emphasized. There is no mortality from the procedure itself, and the morbidity was limited to lower-extremity edema in three patients who otherwise could have been expected to develop PE. The edema lasted two months in one patient and cleared rapidly in the other two. Attesting to the procedure's effectiveness, there were no cases of recurrent PE. Caval partition is an appealing mode of prophylaxis in high-risk patients because of its safety, efficacy, and permanence.
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Kusminsky et al. (1982) conducted an observational in Colonic operations with risk of postoperative pulmonary embolism (n=30). Incidental prophylactic inferior vena cava clipping (IVCC) was evaluated on recurrent pulmonary embolism (PE). Prophylactic inferior vena cava clipping in 30 patients undergoing colonic operations resulted in 0 cases of recurrent pulmonary embolism and no procedure-related mortality.
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