Mode of Gynecologic Surgery and Risk for Post-Op Venous Thromboembolism
BACKGROUND AND PURPOSE:
Determining the incidence of Venous Thromboembolism (VTE) as it relates to type of gynecologic surgery (minimally invasive vs open surgery) is important for the development of evidence based VTE prophylactic guidance
Jorgensen et al. (Obstetrics & Gynecology, 2018) assessed the relationship between mode of gynecologic surgical incision and incidence of postoperative VTE
Retrospective cohort study
Participants: women who underwent gynecologic surgery
Billing and diagnosis codes were used to identify surgery and cases of venous thromboembolism
43,751 surgeries | 37,485 patients
Incidence of VTE
All gynecologic surgeries: 0.2%
Compared to laparoscopy, minimally invasive gynecologic surgery was less likely to result in VTE
Laparoscopy: Risk ratio (RR) 0.22 (95% CI 0.13–0.37)
Vaginal: RR 0.07 (95% CI 0.04–0.12)
Decreased risk of VTE was still present when adjusted for other related risk factors
VTE is rare following gynecologic surgery, especially using minimally invasive techniques
The authors state
Because current practice guidelines do not account for mode of surgery, we find them to be insufficient for the modern gynecologic surgeon to counsel patients on their individual venous thromboembolism risk or to make ideal decisions regarding selection of thromboprophylaxis.
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