Lower Limb Doppler Ultrasound Prior to Pneumatic Compression for the Prevention of Pulmonary Embolism in Gynecological Cancer Patients: A Retrospective Cohort Study

TL;DR

This study examined whether using Doppler ultrasound before surgery helps prevent blood clots in gynecological cancer patients.

Contribution

The study provides new evidence on the effectiveness of preoperative Doppler screening in preventing venous thromboembolism in gynecological oncology.

Findings

Doppler screening detected preoperative deep vein thrombosis in 7.7% of patients.

Postoperative pulmonary embolism or deep vein thrombosis rates were similar between screened and unscreened groups.

No significant difference in postoperative complications was found between the two groups.

Abstract

Introduction: Venous thromboembolism, which includes deep-vein thrombosis and pulmonary embolism, is the third most common cardiovascular disease after myocardial infarction and stroke. This study aimed to determine the effect of Doppler ultrasound on the prophylaxis and prevention of postoperative venous thromboembolism in gynecological oncology.

Method: This is a retrospective cohort study of procedures performed at King Abdulaziz Medical City in Jeddah, Saudi Arabia, between 2016 and 2021. The study included all patients diagnosed with gynecological cancers who underwent major cancer resection. A total of 295 eligible patients were enrolled and divided into two groups: the first group consisted of 104 patients who were screened for deep vein thrombosis using lower limb Doppler ultrasound prior to their gynecologic oncology surgery, while the second group included 190 patients who were not screened.

Results: The prevalence of pulmonary embolism and/or deep vein thrombosis was found to be eight out of 104 patients (7.7%) in the group screened for deep-vein thrombosis using lower limb Doppler ultrasound prior to their gynecologic oncology surgery. In the group that was not screened, one out of 190 patients (0.5%) developed deep vein thrombosis. The prevalence of postoperative pulmonary embolism and/or deep-vein thrombosis was reported in four out of 104 screened patients (3.8%) and in three out of 190 patients (1.6%) in the unscreened group.

Conclusion: This study concluded that Doppler screening did not change the incidence of pulmonary embolism and/or deep-vein thrombosis postoperatively, but it may be helpful in detecting these conditions preoperatively. Therefore, Doppler screening for deep-vein thrombosis before surgical procedures in gynecological oncology could be considered after clinical assessment of the patient. To improve the study and address its limitations, a larger sample size would help to further investigate and identify relevant factors and determine their significance.

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