Extended Venous Thromboembolism Prophylaxis after Robotic Staging for Endometrial Cancer

Area of Science:

• Gynecologic Oncology
• Surgical Oncology
• Pharmacology

Background:

• Robotic surgical staging for endometrial cancer is increasingly common.
• Venous thromboembolism (VTE) is a significant postoperative complication.
• Optimal VTE prophylaxis strategies require further investigation.

Purpose of the Study:

• To determine the incidence of VTE following robotic staging for endometrial cancer.
• To compare VTE rates between single-dose preoperative enoxaparin and extended postoperative enoxaparin prophylaxis.

Main Methods:

• Retrospective chart review of 148 patients undergoing robot-assisted endometrial cancer staging.
• Two groups: preoperative prophylaxis (PP) with single-dose enoxaparin, and extended prophylaxis (EP) with 28-day enoxaparin.
• VTE incidence assessed within 30 days postoperatively.

Main Results:

• Overall VTE incidence was 0.67%.
• No significant difference in VTE rates between PP (0.9%) and EP (0%) groups (P=1.00).
• PP group had higher blood loss and longer operative times, with more lymph node dissections.

Conclusions:

• The incidence of VTE after robotic endometrial cancer staging is low (0.67%).
• Single-dose preoperative enoxaparin is non-inferior to extended postoperative prophylaxis for VTE prevention.
• Mechanical prophylaxis plus a single preoperative dose of enoxaparin may be sufficient for low-risk patients.