Impact of intermittent pneumatic compression stockings on pulmonary embolism rates after laryngectomy: A...

Total laryngectomy is a common procedure for laryngeal and hypopharyngeal carcinoma, but due to its long surgical duration and the underlying malignancy it is linked to a high incidence of pulmonary embolism (PE) and other thromboembolic events, affecting clinical outcomes. This study aimed to compare the impact of perioperative intermittent pneumatic compression stockings (IPCS) and medical thrombosis prophylactic stockings (MTPS) on thromboembolic incidence.

This single-center retrospective study included 98 patients who underwent total laryngectomy between March 2018 and March 2024. Patient records and an electronic database were reviewed for thromboembolic events. From March 2021 onward, IPCS replaced MTPS, enabling a before-after comparison. To assess the effect of IPCS on PE, an inverse probability of treatment weighted (IPTW) logistic regression model was used, accounting for comorbidities and perioperative risk factors.

In our cohort, 13 patients (13%) developed pulmonary embolism (PE). A history of thromboembolic events significantly increased PE risk (OR 17.8, p = 0.015). Postoperative bleeding occurred in 5.1% of patients and was associated with a higher PE incidence. IPCS use significantly reduced PE risk (adjusted OR 0.0508, unadjusted OR 0.1080) in the IPTW model.

IPCS significantly reduced PE risk compared to MTPS, indicating definite prophylactic benefits. Patients with a history of thromboembolic events are at higher risk for PE after laryngectomy, which also increases the risk of postoperative bleeding and reoperation due to the required anticoagulation.