[in Japanese]

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A gynecologic malignancy is a risk for venous thromboembolism (VTE) in perioperative period. Especially, pulmonary thromboembolism (PTE) is a life-threatening event after surgery resulting from deep vein thrombosis. We retrospectively analyzed the efficacy of VTE prophylaxis by anticoagulant treatment in VTE “high risk” patients with gynecologic malignancies who underwent surgery at Yamagata University Faculty of Medicine from January 2009 through March 2011. Total number of eligible patients, who were classified as high risk, in this study was 167. For “high risk” patients, we applied the VTE prophylaxis by IPC to 82 patients (IPC-only group), while post-operative anticoagulant (AC) therapy in addition to IPC was employed in 85 patients (IPC+AC group). We evaluated the incidence of symptomatic PTE after surgery in IPC-only and IPC+AC groups. Occurrences of symptomatic PTE in the IPC-only group and IPC+AC group were 5 out of 82 (6.1%) and 2 out of 85 (2.4%), respectively. Although the incidence in IPC+AC group tended to be lower than that in IPC-only group, there was no significant difference between the groups. Considering the fact that PTE occurred at day 1 or 2 postsurgery, combined VTE prophylaxis by IPC and early introduction of anticoagulant therapy could reduce the symptomatic PTE after surgery in “high risk patients” with gynecologic malignancies.

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