VENOUS THROMBOEMBOLISMS FOLLOWING LAPAROSCOPIC HYSTERECTOMY FOR BENIGN DISEASE IN A DANISH COHORT

Problem statementPostoperative venous thromboembolism (VTE) is a common complication following gynaecologic procedures, particularly for women undergoing open surgery or with malignancy. However, there is limited knowledge about the risk of postoperative VTE after laparoscopic hysterectomy. Based on retrospective studies VTE risk appears to be present but low which has led authors to discuss whether thromboprophylaxis (TP) is indicated. Recommendations for TP in women undergoing minimally invasive gynaecologic surgery are not well established and to date there are no evidence-based guidelines that specifically provide recommendations to prevent VTE-events in this patient category. Consequently, gynaecologic departments in Denmark have different local guidelines.The aim of our project was to investigate the incidence of VTE and the current use of thromboprophylaxis in Danish women undergoing laparoscopic hysterectomy for benign disease.MethodsWomen who underwent hysterectomy for benign indication between January 1st 2015 and December 31st 2017 were included. The Danish Hysterectomy and Hysteroscopy Database (DHHD) and the DanishNational Patient Registry were used to collect relevant data concerning patient and operation characteristics, postoperative complications and thromboprophylaxis.Information about the current use of thromboprophylaxis in Denmark was retrieved through electronic surveys sent to all Gynecologic departments in Denmark reporting data to DHHD.ResultsOngoing study, preliminary results are presented. Out of 11731 hysterectomized women, 81% (n=9507) underwent minimally invasive hysterectomy in which 66% (n=7739) were laparoscopic. Pharmacologic TP was used in 86% (n=6646) of laparoscopic hysterectomies.Data from the electronic survey were provided by 25 Gynecologic departments in Denmark (83%). Eighty-eight percent gave TP to all patients, while 12% only to high risk patients. Pharmacological TP was used by 88%, most commonly used was Fragmin ranging in doses between 2500 and 5000 IE. Mechanical TP with perioperative thromboembolic- deterrent (TED)-stockings was used by 56%.Data concerning the incidence of VTE out of 7739 laparoscopic hysterectomies will be completed in November 2019.ConclusionOur preliminary results suggest that the majority of women undergoing laparoscopic hysterectomy in Denmark are given thromboprophylaxis. The type and dosage vary between departments.