Extended Venous Thromboembolism Prophylaxis after Robotic Staging for Endometrial Cancer

Alicia Palmieri, Verda Hicks, Noelle Aikman, Mark Borowsky, Ashley Haggerty, Karim Elsahwi

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives Our objectives were to estimate the incidence of venous thromboembolism (VTE) after robotic staging for endometrial cancer and to compare the incidence of VTE in patients who received a single dose of preoperative prophylaxis of enoxaparin with those who received extended postoperative prophylaxis. Methods This study is a retrospective chart review of patients who underwent robot-assisted surgical staging for endometrial cancer. Patients were categorized into two groups: preoperative prophylaxis (PP), patients who received a single dose of enoxaparin preoperatively, and extended prophylaxis (EP), patients who received 28 days of enoxaparin postoperatively. Results In total, 148 patients were included, with 117 patients in the PP group and 31 patients in the EP group. The overall incidence of VTE within 30 days postoperatively was 0.67%. No significant difference was found between the PP and the EP groups (0.9% and 0%, respectively; P = 1.00). Most patients in the cohort had endometrioid adenocarcinoma (78%) with low-grade disease (70%), although there were a greater number of patients in the PP group with uterine serous carcinoma compared with the EP group (17% vs 10%; P = 0.034). The PP group had higher estimated blood loss (106 vs 81 mL; P = 0.009) and longer operative times (178 vs 151 min; P = 0.028) compared with the EP group. Significantly more patients in the PP group underwent lymph node dissection compared with the EP group (32% vs 7%; P = 0.008). Conclusions The incidence of VTE following robot-assisted surgical staging for endometrial cancer in this study was 0.67%. No significant difference was found in VTE incidence between the PP group compared with the EP group. Mechanical prophylaxis plus a single dose of preoperative pharmacologic prophylaxis may suffice for low-risk patients following robotic surgical staging for endometrial cancer.

Original languageEnglish
Pages (from-to)790-794
Number of pages5
JournalSouthern Medical Journal
Volume116
Issue number10
DOIs
StatePublished - Oct 1 2023

ASJC Scopus subject areas

  • General Medicine

Keywords

  • endometrial cancer
  • mechanical venous thromboembolism (VTE) prophylaxis
  • pharmacologic VTE prophylaxis
  • postoperative VTE

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