TY - JOUR T1 - Perioperative Venous Thromboembolism in Patients with Gynecological Malignancies: A Lesson from Four Years of Recent Clinical Experience JF - Anticancer Research JO - Anticancer Res SP - 3589 LP - 3595 VL - 34 IS - 7 AU - AKIKO MORIMOTO AU - YUTAKA UEDA AU - TAKESHI YOKOI AU - YUKI TOKIZAWA AU - KIYOSHI YOSHINO AU - MASAMI FUJITA AU - TOSHIHIRO KIMURA AU - EIJI KOBAYASHI AU - SHINYA MATSUZAKI AU - TOMOMI EGAWA-TAKATA AU - KENJIRO SAWADA AU - TATEKI TSUTSUI AU - TADASHI KIMURA Y1 - 2014/07/01 UR - http://ar.iiarjournals.org/content/34/7/3589.abstract N2 - Aim: To analyze clinical characteristics of venous thromboembolisms (VTE) in gynecological malignancies, and to find a cost-effective prophylaxis procedure for post-operative VTE. Patients and Methods: We analyzed clinical characteristics of 751 patients who underwent definitive surgery for gynecologic malignancies, and cost-effectiveness of VTE prophylaxis. Results: VTE was diagnosed preoperatively in 4.5% of ovarian cancer cases, more frequently than any other type (p<0.005). Older age and greater length of operation were independent risk factors for postoperative VTE. To prevent eight VTEs in 738 malignant cases, which occurred during day 2 to 10, $617,783, $726,185, or $994,222 were necessary for continuous VTE prophylaxis, using either unfractionated heparin (UFH), low-molecular weight heparin or fondaparinux, respectively. Conclusion: A strategy which might be cost-effective for post-surgical management of gynecological malignances is use of UFH three times combined with graduated compression stockings and intermittent pneumatic compression, thorough SpO2 monitoring, and perioperative measurements of the circumference of both sides of thighs and calves. ER -