TY - JOUR
T1 - Postsurgery outcomes in patients with polycythemia vera and essential thrombocythemia
T2 - A retrospective survey
AU - Ruggeri, Marco
AU - Rodeghiero, Francesco
AU - Tosetto, Alberto
AU - Castaman, Giancarlo
AU - Scognamiglio, Francesca
AU - Finazzi, Guido
AU - Delaini, Federica
AU - Micò, Caterina
AU - Vannucchi, Alessandro M.
AU - Antonioli, Elisabetta
AU - De Stefano, Valerio
AU - Za, Tommaso
AU - Gugliotta, Luigi
AU - Tieghi, Alessia
AU - Mazzucconi, Maria Gabriella
AU - Santoro, Cristina
AU - Barbui, Tiziano
PY - 2008/1/15
Y1 - 2008/1/15
N2 - A multicenter retrospective analysis was performed to estimate the frequency of thrombosis and hemorrhage after surgical procedures in patients with polycythemia vera (PV) and patients with essential thrombocythemia (ET). Data from 105 patients with PV and 150 patients with ET were analyzed, for a total of 311 surgical interventions. An emergency procedure was performed in 25 (8.1%) patients; 194 surgeries were done under general anesthesia, and 21 (23%) of 91 abdominal interventions were done under laparoscopy; 155 (50.1%) were major surgeries. Subcutaneous heparin was administered in 169 (54.3%) of 311 cases and antiplatelet therapy in 48 (15.4%) of 311 case interventions. One hundred eighty-eight (74%) of 255 patients were on cytoreductive therapy before surgery. No events were observed in 259 (83.2%) of 311 procedures during 3 months of follow-up; there were 12 arterial and 12 venous thrombotic events, 23 major and 7 minor hemorrhages, and 5 deaths. Arterial thromboses were more frequent in ET (5.3% vs 1.5%; P = .08), venous events were more frequent in PV (7.7% vs 1.1%; P = .002). There was not a correlation between bleeding episodes and the type of diagnosis, use of antithrombotic prophylaxis, or type of surgery. A high proportion of PV and ET surgeries was complicated by vascular occlusion (7.7%) or by a major hemorrhage (7.3%). Prospective investigations analyzing the optimal prophylaxis in these patients are suggested.
AB - A multicenter retrospective analysis was performed to estimate the frequency of thrombosis and hemorrhage after surgical procedures in patients with polycythemia vera (PV) and patients with essential thrombocythemia (ET). Data from 105 patients with PV and 150 patients with ET were analyzed, for a total of 311 surgical interventions. An emergency procedure was performed in 25 (8.1%) patients; 194 surgeries were done under general anesthesia, and 21 (23%) of 91 abdominal interventions were done under laparoscopy; 155 (50.1%) were major surgeries. Subcutaneous heparin was administered in 169 (54.3%) of 311 cases and antiplatelet therapy in 48 (15.4%) of 311 case interventions. One hundred eighty-eight (74%) of 255 patients were on cytoreductive therapy before surgery. No events were observed in 259 (83.2%) of 311 procedures during 3 months of follow-up; there were 12 arterial and 12 venous thrombotic events, 23 major and 7 minor hemorrhages, and 5 deaths. Arterial thromboses were more frequent in ET (5.3% vs 1.5%; P = .08), venous events were more frequent in PV (7.7% vs 1.1%; P = .002). There was not a correlation between bleeding episodes and the type of diagnosis, use of antithrombotic prophylaxis, or type of surgery. A high proportion of PV and ET surgeries was complicated by vascular occlusion (7.7%) or by a major hemorrhage (7.3%). Prospective investigations analyzing the optimal prophylaxis in these patients are suggested.
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U2 - 10.1182/blood-2007-07-102665
DO - 10.1182/blood-2007-07-102665
M3 - Article
C2 - 17909074
AN - SCOPUS:38349175356
VL - 111
SP - 666
EP - 671
JO - Blood
JF - Blood
SN - 0006-4971
IS - 2
ER -