Introduction Air travel and cancer surgery are associated with increased risk of venous thromboembolism (VTE). We sought to investigate the incidence of postoperative VTE in gynecologic oncology patients who flew before and after surgery, prior to the era of routine postoperative extended VTE prophylaxis.
Methods A retrospective cohort study identified 136 patients having travelled by air to and from surgery between 2008–2017. All patients underwent laparoscopy or laparotomy for suspected or confirmed gynecologic malignancy at a single tertiary cancer care centre. Medical records were reviewed for demographic, medical and outcome data, including diagnosis of VTE within 30 days of surgery.
Results The combined incidence of VTE (deep venous thromboembolism or pulmonary embolism) was 1.5%. One patient experienced a pulmonary embolism and one an upper extremity deep vein thrombosis. Both had advanced ovarian cancer and underwent debulking surgery (primary debulking and interval debulking). Only five patients in this cohort were discharged with extended duration anticoagulation due to a history of previous VTE. Sixty-two percent underwent laparotomy, of which 52% were debulking surgeries. Among these patients, 67% received neoadjuvant chemotherapy. Sixteen percent of patients had upper abdominal surgery and 48% a pelvic and/or para-aortic lymph node dissection.
Conclusion/Implications Although extended VTE prophylaxis was not routinely administered, the incidence of postoperative VTE was low. Within the Canadian context, where centralized cancer care often requires patients to travel long-distances to access specialized services, these findings offer additional reassurance that the postoperative risk of VTE is low even in this high-risk population.
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