Risk of venous thromboembolism in abdominal versus minimally invasive hysterectomy for benign conditions

Barber, Emma L.; Neubauer, Nikki L.; Gossett, Dana R.

doi:10.1016/j.ajog.2014.12.006

Cited by 53 publications

(47 citation statements)

References 14 publications

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“…Additionally, data collection methods in our data source have been found to be reliable and accurate (10) and are robust in detecting postoperative complications, particularly those that occur after hospital discharge, compared to claims-based data sources (9). Finally, this data source has been used to study venous thromboembolism in many surgical disciplines and was the data source for the highly cited validation of the Caprini score (25–29). …”

Section: Discussionmentioning

confidence: 99%

Venous Thromboembolism in Minimally Invasive Compared With Open Hysterectomy for Endometrial Cancer

Barber

Gehrig

Clarke‐Pearson

2016

Obstetrics &Amp; Gynecology

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Objective To evaluate whether minimally invasive surgery for endometrial cancer is independently associated with a decreased odds of venous thromboembolism compared with open surgery. Methods We performed a secondary analysis cohort study of prospectively collected quality improvement data and examined patients undergoing hysterectomy for endometrial cancer from 2008–2013 recorded in the National Surgical Quality Improvement Program database. Patients undergoing minimally invasive (laparoscopic or robotic) versus open surgery were compared with respect to 30-day postoperative venous thromboembolism. Demographic and procedure variables were examined as potential confounders. Data regarding receipt of perioperative venous thromboembolism prophylaxis was not available. Bivariable tests and logistic regression were used for analysis. Results Of 9,948 patients who underwent hysterectomy for the treatment of endometrial cancer, 61.9% underwent minimally invasive surgery and 38.1% underwent open surgery. Patients undergoing minimally invasive surgery had a lower venous thromboembolism incidence (0.7%, n=47) than open surgery patients (2.2%, n=80) (p<0.001). In a multivariate model adjusting for age, BMI, race, operative time, Charlson comorbidity score, and surgical complexity, minimally invasive surgery remained associated with decreased odds of venous thromboembolism (aOR 0.36, 95% CI 0.24–0.53) compared with open surgery. Conclusions Minimally invasive surgery for the treatment of endometrial cancer is independently associated with decreased odds of venous thromboembolism compared with open surgery.

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Section: Discussionmentioning

confidence: 99%

Venous Thromboembolism in Minimally Invasive Compared With Open Hysterectomy for Endometrial Cancer

Barber

Gehrig

Clarke‐Pearson

2016

Obstetrics &Amp; Gynecology

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“…13 By comparison, the incidence of VTE after open hysterectomy for benign conditions was only 0.6% (81/12,733 patients). 17 Postoperative PE remains the primary cause of mortality after gynecological cancer surgery. 18 Although chemotherapy increases survival in patients with high-risk tumors, it also carries a significant VTE risk.…”

Section: Etiology/risk Factorsmentioning

confidence: 99%

Venous Thromboembolism in Gynecological Malignancy

Cohen

Lim

Davies

2017

Int J Gynecol Cancer

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Gynecological malignancy-associated VTE is associated with significant morbidity, contributing to a large number of life years lost. Although promising new therapies are emerging, a 2-pronged approach is required to simultaneously target cancer-specific management and predict early on those who are likely to be affected. In the meantime, clinicians should continue to combine current guidelines with a multidisciplinary team approach to ensure that these complex patients receive the best evidence-based and compassionate care.

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“…Many have noted that minimally invasive surgery among gynecologic oncology patients is associated with a lower risk of postoperative venous thromboembolism, ranging from 0.4–2.2% [56–60]. Furthermore, comparison studies between patients undergoing minimally invasive gynecologic surgery and open gynecologic surgery, including patients undergoing surgery for endometrial cancer, have found that open surgery is associated with an increased odds of postoperative venous thromboembolism even when the differing prevalence of risk factors between the two groups are adjusted for [52, 61]. …”

Section: Special Populationsmentioning

confidence: 99%

Prevention of venous thromboembolism in gynecologic oncology surgery

Barber

Clarke‐Pearson

2017

Gynecologic Oncology

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Gynecologic oncology patients are at a high-risk of postoperative venous thromboembolism and these events are a source of major morbidity and mortality. Given the availability of prophylaxis regimens, a structured comprehensive plan for prophylaxis is necessary to care for this population. There are many prophylaxis strategies and pharmacologic agents available to the practicing gynecologic oncologist. Current venous thromboembolism prophylaxis strategies include mechanical prophylaxis, preoperative pharmacologic prophylaxis, postoperative pharmacologic prophylaxis and extended duration pharmacologic prophylaxis that the patient continues at home after hospital discharge. In this review, we will summarize the available pharmacologic prophylaxis agents and discuss currently used prophylaxis strategies. When available, evidence from the gynecologic oncology patient population will be highlighted.

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Risk of venous thromboembolism in abdominal versus minimally invasive hysterectomy for benign conditions

Cited by 53 publications

References 14 publications

Venous Thromboembolism in Minimally Invasive Compared With Open Hysterectomy for Endometrial Cancer

Venous Thromboembolism in Minimally Invasive Compared With Open Hysterectomy for Endometrial Cancer

Venous Thromboembolism in Gynecological Malignancy

Prevention of venous thromboembolism in gynecologic oncology surgery

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