Venous Thromboembolism Prophylaxis in Gynecologic Surgery

Rahn, David D.; Mamik, Mamta M.; Sanses, Tatiana; Matteson, Kristen A.; Aschkenazi, Sarit; Washington, Blair B.; Steinberg, Adam C.; Harvie, Heidi S.; Lukban, James; Uhlig, Katrin; Balk, Ethan M; Sung, Vivian W.

doi:10.1097/aog.0b013e318232a394

Cited by 92 publications

(60 citation statements)

References 26 publications

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“…[28] Jinekolojik cerrahi topluluğu, VTE risk grubunda olan hastalarda profilaksi için mekanik ve farmakolojik tedavinin birlikte uygulanması gerektiğini belirtmektedir. [29] Bu yazıda sunduğumuz hastanın sekiz aylık gebe iken acil sezaryen ameliyatı geçirmesi ve iki taraflı ayak bileği bimalleoler kırık tespiti nedeniyle ameliyat sonrası dönemde hemen yürüyememe riskinin olmasından dolayı VTE ile PE açısından yüksek risk grubuna dahil olması söz konusu idi. Hastaya erken ameliyat sonrası dönemde rehabilitasyon başlanmasının ve düşük molekül ağır-lıklı heparin tedavisi ile kombine edilmesinin semptomatik VTE ve ölümcül PE gibi önemli komplikasyonların engellenmesine katkı sağladığı görüşündeyiz.…”

Section: Discussionunclassified

Treatment of a pregnant patient with bilateral traumatic bimalleolar ankle fracture: a case report

Atıcı

Üzümcügil

Yalçınkaya

et al. 2013

Eklem Hastalik Cerrahisi

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Ayak bileği kırıkları, iskelet travmaları sonrası oluşan tüm kırıklar içerisinde giderek artan sıklıkta görülmektedir. Tüm ayak bileği kırıklarının yaklaşık %25'ini bimalleoler kırıklar oluşturmaktadır. İki taraflı travmatik bimalleoller ayak bileği kırığı ise çok nadir görülen bir durumdur. Bu tablo içerisinde aynı zamanda sezaryen doğum ile müdahale edilmiş gebelik durumunun olması, olguyu özellikle venöz tromboembolizm ve ölümcül pulmoner emboli yönünden daha da komplike hale getirmektedir. Bu yazıda, sekiz aylık gebelik öyküsü bulunan ve araç içi trafik kazası sonucu iki taraflı bimalleoler ayak bileği kırığı olan 25 yaşındaki kadın olgu sunuldu ve uygulanan cerrahi tedavi sonrası elde edilen klinik ve radyolojik sonuçlar literatür ışığında tartışıldı.Anahtar sözcükler: Ayak bileği; iki taraflı; bimalleoler kırık; gebelik.The incidence of ankle fractures has been increasing among all fractures due to skeletal traumas. Bimalleolar fractures account for 25% of all ankle fractures. Bilateral traumatic bimalleolar ankle fracture is a very rare condition. In such a clinical presentation, pregnancy managed with cesarean procedure complicates the situation due to increased risk of venous thromboembolism and fatal pulmonary embolism. In this article, we report a 25-year-old female case within an eight-month pregnancy period who had bilateral bimalleolar ankle fracture due to an accident in a motor-vehicle and the clinical and radiological results of surgical treatment were discussed in the light of current literature data.

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Section: Discussionunclassified

Treatment of a pregnant patient with bilateral traumatic bimalleolar ankle fracture: a case report

Atıcı

Üzümcügil

Yalçınkaya

et al. 2013

Eklem Hastalik Cerrahisi

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“…According to previous systematic reviews, 7,12 there are only two RCT that have compared the use of anticoagulants and IPC in surgical patients with gynecologic malignancy (Table 6). 15 16 We speculate that the lower sensitivity of the VTE detection method they used (i.e., bilateral lower extremities Doppler) might have affected their results.…”

Section: Discussionmentioning

confidence: 99%

“…In view of that, conclusions drawn from those studies may not necessarily be applicable to patients with gynecologic malignancy, considering the thrombophilic nature specific to gynecologic malignancy and surgical procedures. 7 Third, a difference in the regimen of thromboprophylactic drugs exists between Japan and Western countries. In Japan, drug labels for major thromboprophylactic drugs (e.g.…”

Section: Introductionmentioning

confidence: 99%

Randomized controlled trial of enoxaparin versus intermittent pneumatic compression for venous thromboembolism prevention in Japanese surgical patients with gynecologic malignancy

Nagata

Tanabe

Takakura

et al. 2015

J of Obstet and Gynaecol

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Aim: The aim of this study was to compare the efficacy and safety of enoxaparin and intermittent pneumatic compression (IPC) for venous thromboembolism (VTE) prevention in Japanese surgical patients with gynecologic malignancy. Material and Methods: Patients ≥40 years old undergoing major surgery for gynecologic malignancy without preoperative VTE were included. Written informed consent was obtained. Enrolled patients received IPC immediately before surgery. After surgery, they were randomly assigned to either an enoxaparin group or an IPC-alone group. The enoxaparin group received enoxaparin injection (20 mg, subcutaneous, every 12 h) from postoperative day 2 to 8. IPC was discontinued after the first injection. In the IPC-alone group, IPC was continued until full ambulation. The primary end-point was incidence of VTE, including pulmonary embolism and deep vein thrombosis, regardless of symptoms. An interim analysis was to be conducted when the first 30 patients had completed the study protocol. A Data and Safety Monitoring Board was established for making recommendation on the continuation or termination of the study based on the interim results. Results: At the time of the interim analysis, six cases of VTE were found: five in the IPC-alone group and one in the enoxaparin group (Fisher's exact test, P = 0.08). Three patients in the IPC-alone group developed pulmonary embolism, but none in the enoxaparin group did so (Fisher's exact test, P = 0.10). The study was terminated following the Data and Safety Monitoring Board's recommendation. Conclusion: Enoxaparin might have lowered the risk of VTE among surgical patients with gynecologic malignancy. Further studies are necessary to confirm this.

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“…33 Rahn ve ark.nın oluşturduğu bir sistematik derlemede ise pnömo-tik mekanik basınç sağlayan çorap ve düşük molekül ağırlıklı heparin (DMAH) kullanımının, benign cerrahi yapılan jinekoloji hastalarının ço-ğunda yeterli profilaksi sağladığı vurgulanmış-tır. 34 Ayrıca, hormon replasman tedavisi ve kombine oral kontraseptif alan hastaların ilacı bı-rakmaları ya da cerrahi öncesi alternatif yöntem kullanmaları gerektiği hususunda uyarılmaları gerekmektedir. 35 …”

Section: Tromboemboli Profilaksisiunclassified

A New Approach to Evidence Based Practices in Gynecological Surgery: ERAS Protocol and Nursing

Aksoy¹,

Yılmaz²

2018

Turkiye Klinikleri J Nurs Sci

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Venous Thromboembolism Prophylaxis in Gynecologic Surgery

Abstract: Intermittent pneumatic compression provides sufficient prophylaxis for the majority of gynecology patients undergoing benign surgery. Additional risk factors warrant the use of combined mechanical and pharmacologic prophylaxis.

Cited by 92 publications

References 26 publications

Treatment of a pregnant patient with bilateral traumatic bimalleolar ankle fracture: a case report

Treatment of a pregnant patient with bilateral traumatic bimalleolar ankle fracture: a case report

Randomized controlled trial of enoxaparin versus intermittent pneumatic compression for venous thromboembolism prevention in Japanese surgical patients with gynecologic malignancy

A New Approach to Evidence Based Practices in Gynecological Surgery: ERAS Protocol and Nursing

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