Introduction/Background*All surgeons are in concern for thromboembolic events especially following a major operation for cancer. The aim of this audit is to report the incidence of PE in our oncology department, to identify risk factors and help us design future studies in order to reduce the incidence of PE and provide the best healthcare services in our patients.
Methodology The Metaxa anti-cancer hospital database was reviewed to identify patients who had surgery performed for gynecologic malignancy from March 2019 to March 2021. Age, BMI, smocking status, final pathologic diagnosis, FIGO stage, surgical procedure(s) were recorded.
Result(s)*We identified 174 patients who had gynecologic surgery for malignancy between March 2019 and March 2021 in our department. The incidence of PE among these patients was 4% (7/174) (table 1).
Within the cohort of minor cases, 2 of 64 (3.1%) developed PE in the postoperative period. Within the cohort of major cases 5 of 110 (4.5%) developed PE. Among 110 cancer patients with major procedure, 38 of them temporally interrupted LMWH day 0 and 72 of them did not. 2 of the first group and 3 of the second developed PE (2/38=5.2% vs 3/72=4.1 respectively). Most of the cases of PE developed in patients with high stage ovarian cancer with BMI>30 (table 2).
Conclusion*Gynecologic oncology patients who had abdominal surgery have higher risk of venous thromboembolism. Ovarian cancer patients are in greater danger among the rest.
As far as the interruption of prophylactic thromboembolic dose of LWMH the Day 0 seems to have no increased risk in PE development but in order to conclude safer results we need to design a randomized control trial to compare the two arms.
In order to reduce PE risk we also need to analyze the data from MeThos trial, in which our department participates and it is still running.
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