INTRODUCTION Historically, the development of venous thromboembolism (VTE) including deep venous thrombosis (DVT) and pulmonary thromboembolism (PE) was cited as a higher post-operative risk for patients harboring meningiomas. However, recent literature has suggested that there may be no elevated risk for VTE among these patients. The authors perform both a retrospective review of their own cases as well as a systematic review of the literature in order to determine the frequency of the VTE and rate of post-operative hemorrhage in this patient population. METHODOLOGY Patients undergoing surgery for intracranial and spinal meningioma from 2012 to 2019 were retrospectively reviewed for patient demographics, clinical characteristics, and post-operative complications. Logistic regression was used to determine risk factors for the development of VTE. Additionally, a PubMed search was performed to identify patients addressing this topic. RESULTS Our retrospective review included 189 patients who underwent 197 operations. The rate of VTE for patients receiving LMWH was 3.55 % vs. 4.06 % for those not receiving LMWH. There were no observed hemorrhages after initiation of LMWH. Multivariate analysis found tumor volume, history of DVT, and length of hospital stay as independent risk factors for VTE. In the systematic review, 11 papers describing 28,954 patients were included. The risk of developing a VTE with or without LMWH was 2.71 % versus 4.07 %, respectively. The hemorrhage risk was 2.23 % on LMWH versus 4.20 % not on LMWH. DISCUSSION In several heterogeneous series of all types of neurosurgical procedures, the reported rate of VTE was 11.1 %. In our review of the literature, the VTE rate of 2.71 % was similar to our cohort's rate of 3.55 %, for patients administered LMWH postoperatively. Higher rates of VTE with meningiomas may not be the case as once thought. Regular use of LMWH appears to be a safe, but it also did not necessarily lower the rates of VTE in our cohort. The use of routine lower-extremity duplex ultrasound, mechanical prophylaxis, and early mobilization, may have contributed to these lower rates of VTEs in patients with meningiomas.

中文翻译：

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颅内和椎管内脑膜瘤手术切除后静脉血栓栓塞的发生率。系统回顾和回顾性研究

引言 历史上，静脉血栓栓塞 (VTE) 包括深静脉血栓形成 (DVT) 和肺血栓栓塞 (PE) 的发展被认为是脑膜瘤患者术后风险较高的因素。然而，最近的文献表明，这些患者中 VTE 的风险可能没有升高。作者对他们自己的病例进行了回顾性审查，并对文献进行了系统审查，以确定该患者群体中 VTE 的频率和术后出血率。方法学 对 2012 年至 2019 年接受颅内和脊椎脑膜瘤手术的患者进行了患者人口统计学、临床特征和术后并发症的回顾性研究。Logistic 回归用于确定发生 VTE 的危险因素。此外，还进行了 PubMed 搜索以识别解决该主题的患者。结果 我们的回顾性研究纳入了 189 名接受 197 次手术的患者。接受 LMWH 的患者的 VTE 率为 3.55 %，而未接受 LMWH 的患者为 4.06 %。LMWH 开始后没有观察到出血。多变量分析发现肿瘤体积、DVT 病史和住院时间是 VTE 的独立危险因素。在系统评价中，纳入了 11 篇论文，描述了 28,954 名患者。有或没有 LMWH 发生 VTE 的风险分别为 2.71 % 和 4.07 %。LMWH 的出血风险为 2.23 %，而非 LMWH 的出血风险为 4.20 %。讨论 在所有类型的神经外科手术的几个异质系列中，报告的 VTE 率为 11.1%。在我们查阅文献时，对于术后接受 LMWH 的患者，2.71 % 的 VTE 发生率与我们队列中 3.55 % 的发生率相似。脑膜瘤的 VTE 发生率较高，可能并非人们想象的那样。经常使用 LMWH 似乎是安全的，但它也不一定会降低我们队列中 VTE 的发生率。常规下肢双工超声、机械预防和早期活动的使用可能是脑膜瘤患者 VTE 发生率较低的原因之一。