2013 Volume 33 Issue 7 Pages 1131-1136
Introduction: The incidence of deep vein thrombosis (DVT) after gastric surgery in Japan has not been adequately studied. We assessed the incidence of DVT using our strategy for the diagnosis of DVT and the efficacy of fondaparinux for the prophylaxis against DVT after gastric cancer surgery. Patients and Methods：Two hundred and seventy-three gastric cancer patients underwent ultrasonography of the lower limbs for the detection of DVT. D-dimer levels were measured 4 times: before surgery, 1, 4, 7 and 14 days after surgery. Patients who were admitted after October 2010 received fondaparinux 2.5 mg subcutaneously once-daily. We examined the incidence of DVT between patients with and without fondaparinux. Results: The DVT incidence was 21%. According to receiver operating characteristic curve analysis, the resulting cut-off value of the D-dimer level 7 days after surgery was 11.0 μg/mL (sensitivity 68%; specificity 75%). DVT was detected in 15% of patients in the fondaparinux group and 28% in the control group. Conclusion: We assessed strategies for diagnosis of DVT combining the use of D-dimer and ultrasonography. Fondaparinux 2.5 mg/day may be a valuable therapeutic option for preventing DVT after gastric surgery.
