ROLE OF ROUTINE DVT PROPHYLAXIS AFTER MAJOR GENERAL SURGICAL PROCEDURE; OUR EXPERIENCE IN A TERTIARY CARE CENTRE OF KOLKATA. Büyük Cerrahi giri?imlerden sonra DVT profilaksisinin rolü; Kolkata’da ü?üncü basamak bir tedavi merkezindeki deneyimimiz.

摘要

According to western literature, venous thromboembolism (VTE), a term encompassing deep vein thrombosis (DVT) and pulmonary embolism, is one of the most common postoperative complications after major surgery. Very few studies have been published on the subject and very little is known about true incidence of condition. There are no clear guidelines regarding the prophylaxis for venous thromboembolism for an Indian patient.A prospective study was carried in the Department of General Surgery, Medical College and hospital, Kolkata to determine the incidence of deep vein thrombosis. Present study included 127 patients undergoing major general surgeries (including abdomen, pelvis and lower extremities) over a 1 year period. All the patients were subjected to Duplex USG between the 7th and 14thpostoperative period. No mechanical and chemical form of DVT prophylaxis was used.Only eight patients (6.29 %) showed sonographic evidence of DVT and the majority of them resolved without treatment. There was no case of pulmonary embolism.Deep vein thrombosis following major general surgery in Indian patients is not as common as reported in the Western literature. A high level of suspicion and close clinical monitoring is mandatory. In our opinion routine chemoprophylaxis is perhaps not justified in every patient undergoing major general surgery, which can be of great help to both mankind and nation.??ZETBat? literatürüne g?re, derin ven trombozu ve pulmoner emboliyi kapsayan ven?z tromboembolizm büyük ameliyatlar sonras?nda kar??m?za ??kan en ciddi komplikasyonlardan birisidir. Konuyla ilgili ?ok say?da ?al??ma yap?lm?? olmakla beraber, ger?ek insidans? bilinmemektedir. Hindistanl? hastalar i?in belirlenmi? bir algoritma henüz tam olarak ortaya konulmam??t?r.Kolkata T?p Fakültesi ve hastanesinde ger?ek ven?z tromboembolizm insidans?n? bulmak i?in prospektif bir ?al??ma yap?ld?. Bir y?l i?erisinde büyük cerrahi giri?im (kar?n, pelvis ve alt ekstremite) yap?lan 127 hasta ?al??maya al?nd?. Bütün hastalara ameliyat sonras?ndaki 7, ve 14. günlerde duplex USG yap?ld?. Ven?z tromboembolizmi ?nlemek i?in kimyasal veya mekanik profilaksik ila? tedavisi yap?lmad?.Hastalar?n 8’inde (%6.29) derin ven trombozuna rastlanmakla beraber, ?o?u herhangibir tedavi almaks?z?n iyile?ti. Pulmoner emboli vakas? g?rülmedi.Sonu? olarak, Hindistan’da büyük ameliyatlar sonras?nda kar??la??lan derin ven trombozu vakalar?n?n s?kl???, Bat? ülkelerine g?re daha az s?kl?kta rastlanm??t?r. Hastal???n her vakada ak?lda tutulmas? ve g?zlem yeterli olmaktad?r. Bizim g?rü?ümüze g?re; büyk cerrahi yap?lan her vakada profilaksi yap?lmas?na gerek olmad???n? dü?ünüyor ve bunun ülke ve insanl?k i?in faydal? olaca??n? dü?ünüyoruz.