The Incidence of Pulmonary Embolism after Gynecologic Oncologic Surgery.

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Background: Pulmonary embolism is a major morbidity following surgery for malignancy. The purpose of this study was to determine the risk of developing a pulmonary embolism in patients having major abdominal surgery during the peri and post-operative period (6 weeks) and to compare cancer and benign subgroups. Methods: The H. Lee Moffitt Cancer Center database was reviewed retrospectively to identify gynecologic oncology patients who had surgery between July 2001-June 2003. These patients were sorted by major or minor procedure, and further by malignant versus benign diagnosis. Pulmonary embolism in post-operative patients was determined from the time of surgery through 6 weeks post-operatively. The diagnosis of pulmonary embolism was confirmed by either a CTPA or V/Q scan. All patients received prophylaxis with sequential compression devices (SCD) and early ambulation. Benign and malignant groups were compared with chi square analysis. This study was IRB approved. Results: A total of 1374 patients were identified between July 2001-June 2003. Chart review identified 1009 major cases and 365 minors. Of the 1009 major surgical cases 836 were exploratory laparotomies with 523 cancer cases and 313 benign cases. In patient with a diagnosis of cancer, 23/523 (4.4%) were diagnosed with pulmonary embolism. In patients with a benign diagnosis, 1/313(0.3%) were diagnosed with a pulmonary embolism. The difference between those with and without cancer was determined to be significant. (p=.0006) Conclusion: We determined the rate of post-operative pulmonary embolism in patients with cancer who have major abdominal surgery to be 4.4%. This rate persisted despite vigorous use of SCD’s and early ambulation. Preventative measures are needed in this subgroup of patients to attempt to decrease this high rate of post-operative pulmonary embolism.


Obstetrics and Gynecology


Department of Obstetrics and Gynecology, Department of Obstetrics and Gynecology Faculty

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