Incidence and Risk Factors of Venous Thromboembolism in Patients Undergoing Surgery for Gynecologic Malignancies

Abstract

Introduction:A potentially fatal complication of gynecological cancer surgery is venous thromboembolism (VTE). Low-molecularweight heparin prophylaxis does not reduce the risk of VTE. This research determined the incidence of VTE and to identify the risk factors in patients having surgery for gynecological malignancy with extended dual prophylaxis.Methods:In this retrospective cohort study, all patients with gynecological cancer undergone surgery at the Division of Gynecologic Oncology of İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine were identified between January 2008 and April 2018. Age, body mass index (BMI), menopausal status, comorbidities, the primary site of the neoplasm in gynecology, surgical details, and operative time, the need for intensive care unit admission, perioperative complications, the patient’s smoking habits, the diagnosis of VTE, and follow-up assessments up to one month after surgery were among the data collected.Results:With a 2.4% incidence rate, 29 of 1,201 analyzed patients experienced postoperative VTE events. BMI >30, operation duration >180 min, paraaortic and/or pelvic lymphadenectomy, neoadjuvant chemotherapy, smoking, and chronic renal failure were revealed to be significant variables [odds ratio (OR): 5.357; 95% confidence interval (CI): 1.833-15.654; p=0.002; OR: 5.698; 95% CI: 1.971-16.474; p=0.001; OR: 0.252; 95% CI: 0.068-0.933; p=0.039; OR: 0.002; 95% CI: 0.001-0.025; p=0.001; OR: 0.217; 95% CI: 0.082-0.577; p=0.002; OR: 0.033; 95% CI: 0.003-0.379; p=0.006, respectively].Conclusion:We suggest that every patient undergoing gynecological oncology surgery should have preoperative pharmacological and postoperative extended dual prophylaxis to achieve the lowest incidence of VTE in this group.

Keywords

• pulmonary embolism
• venous thromboembolism
• gynecological cancer
• postoperative care
• deep vein thrombosis