Incidence of clinical pulmonary embolism after laparoscopic surgery

Background: This study aimed to determine the incidence of pulmonary embolism (PE) following laparoscopic surgery and its potential risk factors. Methods: Data concerning 44453 patients from 114 surgical institutions were collected by the Swiss Association of Laparoscopic and Thoracoscopic Surgery. The incidence of postoperative PE despite thromboprophylaxis was evaluated and potential risk factors were assessed singly, and then in a consecutive stepwise logistic multiple regression analysis. Results: Among 44453 patients assessed, 55.8 percent were female and 44.2 percent were male. Interventions included cholecystectomy (52.8 per cent), hernia repair (17.7 per cent), appendicectomy (12.4 per cent), colonic surgery (4.6 per cent) and oesophageal surgery (5.5 per cent). Postoperative PE occurred in 86 patients (0.2 per cent), and the incidence tended to decrease during this study (P = 0.016). A total of 149 patients died (0.3 per cent) of which nine (6.0 per cent) were due to PE. Significant predictive risk factors were female sex (P < 0.001), age (P < 0.001), weight above 90 kg (P < 0.001), emergency procedure (P < 0.001) and operating time exceeding 150 min (P < 0.001). Conclusion: The low incidence of PE after laparoscopy, with a further decrease over the past decade, suggests a tendency towards improved perioperative thromboembolic risk management.