Gynaecologic Surgery

The overall incidence for DVT in patients undergoing gynaecological surgery is comparable or slightly lower than in general surgical patients. The factors that appear to increase the thromboembolic risk following gynaecologic surgery include advanced age, previous VTE, surgery for cancer, and abdominal (vs vaginal) procedure. Gynaecologic oncology patients, in particular, have a substantially increased DVT risk because many of these patients are elderly; in some there may be compression of major veins by a pelvic mass; they are prone to venous intimal injury during the procedure, especially when pelvic lymph node dissection is performed; the procedures are often lengthy; residual tumor may be left behind; postoperative mobility is often impaired; and chemotherapy itself is thrombogenic. As in other surgical patients, although thrombi generally begin to form at or shortly after surgery, the majority of symptomatic events occur after hospital discharge.