Venous Thromboembolic Complications to Hysterectomy for Benign Disease: A Nationwide Cohort Study

Kahr, Henriette Strøm; Thorlacius-Ussing, Ole; Christiansen, Ole Bjarne; Skals, Regitze Kuhr; Torp‐Pedersen, Christian; Knudsen, Aage

doi:10.1016/j.jmig.2017.11.017

Cited by 20 publications

(15 citation statements)

References 30 publications

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“…A recent Danish nationwide cohort study showed that the use of oral hormonal contraceptives or hormone therapy did not influence the hazard ratio of VTE in women undergoing hysterectomy for benign disease. Most of the patients (58.6%) received postoperative pharmacologic thromboprophylaxis leading up to discharge home [154]. A recent systematic review examining the association of surgical risk with exogenous hormone use in Table 6 Venous thromboembolism prophylaxis recommendations for minimally invasive gynecologic surgery transgender patients concluded that current evidence does not support the need to routinely discontinue all cross-sex hormone therapy before surgery.…”

Section: Hormonal Contraceptives and Hormone Replacement Therapymentioning

confidence: 99%

Enhanced Recovery and Surgical Optimization Protocol for Minimally Invasive Gynecologic Surgery: An AAGL White Paper

Stone¹,

Carey

Fader³

et al. 2021

Journal of Minimally Invasive Gynecology

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This is the first Enhanced Recovery After Surgery (ERAS) guideline dedicated to standardizing and optimizing perioperative care for women undergoing minimally invasive gynecologic surgery. The guideline was rigorously formulated by an American Association of Gynecologic Laparoscopists Task Force of US and Canadian gynecologic surgeons with special interest and experience in adapting ERAS practices for patients requiring minimally invasive gynecologic surgery. It builds on the 2016 ERAS Society recommendations for perioperative care in gynecologic/oncologic surgery by serving as a more comprehensive reference for minimally invasive endoscopic and vaginal surgery for both benign and malignant gynecologic conditions. For example, the section on preoperative optimization provides more specific recommendations derived from the ambulatory surgery and anesthesia literature for the management of anemia, hyperglycemia, and obstructive sleep apnea. Recommendations pertaining to multimodal analgesia account for the recent Food and Drug Administration warnings about respiratory depression from gabapentinoids. The guideline focuses on workflows important to high-value care in minimally invasive surgery, such as same-day discharge, and tackles controversial issues in minimally invasive surgery, such as thromboprophylaxis. In these ways, the guideline supports the American Association of Gynecologic Laparoscopists and our collective mission to elevate the quality and safety of healthcare for women through excellence in clinical practice.

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Section: Hormonal Contraceptives and Hormone Replacement Therapymentioning

confidence: 99%

Enhanced Recovery and Surgical Optimization Protocol for Minimally Invasive Gynecologic Surgery: An AAGL White Paper

Stone¹,

Carey

Fader³

et al. 2021

Journal of Minimally Invasive Gynecology

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show abstract

“…Thus, women with CRF are more likely to need a hysterectomy at a younger age than the general population. However, hysterectomy is a major surgical intervention and is associated with significant operative risks and complications (e.g., infection, organ injury and postoperative thromboembolism) [13,14]. The introduction of endometrial destructive techniques that remove or destroy endometrial tissue has decreased the number of hysterectomies performed in the UK for benign indications by 64%.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency endometrial ablation for treating heavy menstrual bleeding in women with chronic renal failure

Jiang

Xue

2018

International Journal of Hyperthermia

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Objective: The study objective was to retrospectively evaluate the efficacy and safety of radiofrequency endometrial ablation in treating heavy menstrual bleeding (HMB) in women with chronic renal failure (CRF). Method: Fifty-eight patients with CRF undergoing radiofrequency endometrial ablation in our hospital between January 2013 and July 2017 and for whom complete follow-up data were available were included. Outcome measures included amenorrhea, treatment failure and operative complications. Results: The mean patient age was 41.4 ± 7.7 years, the mean preoperative hemoglobin level was 69.6 ± 19.3 g/dL, the mean preoperative serum creatinine level was 879.1 ± 415.4 mmol/L, and the mean urea level was 18.2 ± 7.1 mmol/L. The mean treatment time for radiofrequency endometrial ablation was 61.7 ± 18.8 s. The median volume of estimated blood loss during the procedure was 10 mL (a range of 2-50 mL). On average, the study subjects were monitored for 24.4 months (a range of 6-60 months). The average amenorrhea rate was 89.7%. Only 2 (3.4%) patients required additional gynecologic surgery after endometrial ablation. Intra-and postoperative complications were not observed. Conclusion: Radiofrequency endometrial ablation was demonstrated to be safe and effective for the treatment of HMB in women with CRF.

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“…Among patients undergoing hysterectomy, 58.6% received pharmacologic thromboprophylaxis and 41.4% received no thromboprophylaxis. Multivariate analysis comparing minimally invasive surgery with laparotomy showed that VTE was significantly reduced with laparoscopic hysterectomy (hazard ratio, .51; 95% CI, .28−.92; p = .03) and vaginal hysterectomy (hazard ratio, .39; 95% CI, .24−.63; p < .001) [25].…”

Section: Hysterectomymentioning

confidence: 99%

Venous Thromboembolism in Minimally Invasive Gynecologic Surgery: A Systematic Review

Jorgensen

Hur

2019

Journal of Minimally Invasive Gynecology

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Venous thromboembolism (VTE) is the leading cause of preventable healthcare-related death after surgery. Although there is a large body of research on VTE in the general population as well as risk-assessment tools, evidence specific to the current practices in gynecologic surgery is more sparse. This review article seeks to discuss current literature on VTE in gynecologic surgery, with a focus on minimally invasive surgery. Evidence on risk factors for VTE in gynecologic surgery is evaluated as well as current recommendations use of thromboprophylaxis for prevention of VTE. Despite data showing that minimally invasive gynecologic surgery independently decreases risk of VTE compared with laparotomy, current clinical risk assessment tools and guidelines do not incorporate mode of surgery into recommendations for perioperative VTE prevention.

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Venous Thromboembolic Complications to Hysterectomy for Benign Disease: A Nationwide Cohort Study

Cited by 20 publications

References 30 publications

Enhanced Recovery and Surgical Optimization Protocol for Minimally Invasive Gynecologic Surgery: An AAGL White Paper

Enhanced Recovery and Surgical Optimization Protocol for Minimally Invasive Gynecologic Surgery: An AAGL White Paper

Radiofrequency endometrial ablation for treating heavy menstrual bleeding in women with chronic renal failure

Venous Thromboembolism in Minimally Invasive Gynecologic Surgery: A Systematic Review

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