Martino M A, Williamson E, Rajaram L, Lancaster J M, Hoffman M S, Maxwell G L, Clarke-Pearson D L
Division of Gynecologic Oncology, The Cancer Center at Lehigh Valley Hospital, Penn State Cancer Institute, 400 N. 17th Street, Suite 201, Allentown, PA 18104, USA.
Gynecol Oncol. 2007 Sep;106(3):439-45. doi: 10.1016/j.ygyno.2007.05.001. Epub 2007 Jun 28.
The goal of venous thromboembolism (VTE) prophylaxis is to reduce the morbidity and mortality associated with the development of a deep venous thrombosis (DVT) or pulmonary embolism (PE). Because women with gynecologic cancers are at high risk to develop VTE, we sought to determine the present practice patterns of gynecologic oncologists regarding their use of VTE prophylaxis.
1073 members of the Society of Gynecologic Oncologists (SGO) were mailed surveys that asked about preferred methods to prevent the development of VTE after gynecologic oncology surgery. Data were collected by online member entry and return mail. Frequency distributions were calculated and nonparametric test used for comparisons.
343/1073 (34%) of SGO members and fellows responded. 142/343 (42%) preferred double prophylaxis consisting of external pneumatic compression (EPC) and an anticoagulant while 41% (n=141) preferred EPC with no additional anticoagulation. Of respondents choosing any anticoagulant, 40% preferred Enoxaparin pre- and/or postoperatively. Ovarian cancer patients were perceived by respondents to have the highest risk of developing a postoperative PE.
Most respondents agree that women with gynecologic cancers undergoing major surgery should receive VTE prophylaxis, though there is not agreement as to which method is optimal. While 42% of members preferred double prophylaxis, 41% chose no additional measures other than EPC. Randomized studies in gynecologic oncology should be initiated in the United States to determine the optimal practice pattern.
静脉血栓栓塞症（VTE）预防的目标是降低与深静脉血栓形成（DVT）或肺栓塞（PE）发生相关的发病率和死亡率。由于妇科癌症患者发生VTE的风险较高，我们试图确定妇科肿瘤学家在使用VTE预防措施方面的当前实践模式。
向妇科肿瘤学会（SGO）的1073名成员邮寄调查问卷，询问他们在妇科肿瘤手术后预防VTE发生的首选方法。数据通过在线成员录入和回邮收集。计算频率分布并使用非参数检验进行比较。
343/1073（34%）的SGO成员和研究员做出了回应。142/343（42%）的人倾向于采用由外部气动压迫（EPC）和抗凝剂组成的双重预防措施，而41%（n = 141）的人倾向于仅采用EPC而不额外使用抗凝剂。在选择任何抗凝剂的受访者中，40%的人倾向于术前和/或术后使用依诺肝素。受访者认为卵巢癌患者术后发生PE的风险最高。
大多数受访者同意，接受大手术的妇科癌症患者应接受VTE预防，尽管对于哪种方法是最佳方法尚无共识。虽然42%的成员倾向于双重预防，但41%的人选择除EPC外不采取其他额外措施。美国应开展妇科肿瘤学方面的随机研究，以确定最佳实践模式。
