Thromboembolism prophylaxis in laparoscopic surgery for gynecologic benign diseases. Results of a single center experience in 922 procedures

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COD: 2700_30_06_2017_AOP Categorie: ,

Emanuele Sturlese, Onofrio Triolo, Roberta Grasso, Antonio Simone Laganà,
Annalisa Retto, Diego Rossetti, Salvatore Giovanni Vitale, Giuseppe Sarpietro,
Rosanna De Dominici

Ann Ital Chir, Digital Edition 2017; 6
Epub Ahead of Print – June 30

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AIM: The aim of this study is to assess the role of preoperative evaluation risk for venous tromboembolism (VTE) in
patients submitted to laparoscopic surgery for gynecologic benign diseases.
METHODS: Date from nine hundred twenty-two women affected by adnexal benign diseases treated with laparoscopic
procedures were collected and included in this study. VTE risk was assessed by “on line Caprini score calculator”. Patients
with one or more negative risk factors for Caprini’s score underwent to venous thromboembolism prophylaxis (VTP). The
remainign of the patients did not recived any VTP. A survey was conducted after three months from the discharge in
order to collect the follow up date.
RESULTS: In our study 160 patients had a Caprini’s score major than 2 and they have been subjected to VTP. A total
of 762 patients were considered at low risk for VTE and they did not receive any VTP. In these patients was not registered
any event of VTE.
DISCUSSION: The results of this study suggest that laparoscopic approach, when carried out in non-oncological patients
and without any previous thromboembolic risk factor, is associated with a very low risk of VTE. This study also confirm
what was reported by Ageno et al. 6, Nick et al. 7 and ACCP guidelines in 2012 8 in which routine thromboprophylaxis
is recommended for patients with additional risk factors.
CONCLUSIONS: Laparoscopic surgery in women for gynecologic benign diseases is associated with a very low risk of thromboembolism
and therefore it does not require any mechanical or pharmacological thromboprophylaxis in the absence of
risk factors. The systematic evaluation of VTE risk with the help of a standard calculator is highly recommended.

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