Analysis Of Risk Factors And Treatment Of Perioperative Venous Thromboembolism In Patients With Ovarian Cancer

Objective:The risk of venous thromboembolism(VTE)in patients with ovarian cancer is high,which not only leads to expensive medical costs,but also seriously threatens the life and health of patients.However,there are few studies on the risk factors associated with VTE in patients with ovarian cancer and how to treat patients with ovarian cancer in perioperative period.Here,we aimed to assess the risk factors for venous thromboembolism in these patients,and to explore the prophylaxis and treatment of occurrence of VTE.Methods:We collected and reviewed the records of all patients with epithelial ovarian cancer at Qilu Hospital of Shandong University,from January 1,2014 to January 1,2017.Using different statistical methods,We analyzed risk factors of venous thromboembolism for preoperative and postoperative patients with epithelial ovarian cancer,and that how to protect and treat VTE during perioperative period.Results:Among the 388 patients finally diagnosed with ovarian cancer,34 suffered VTE,including 15 preoperative VTE and 20 postoperative VTE patients.335 patients had no VTE,and 18 patients were excluded.Of 35 cases with venous thrombosis,27 patients were diagnosed with deep venous thrombosis(DVT),while 8 cases were diagnosed with pulmonary embolism(PE),among which 4 PE occurred in preoperative patients,the other 4 in postoperative patients,among which one patient died,the mortality rate for pulmonary embolism is 12.5%.4 patients with PE who we're prior to surgery we're received chemotherapy for 2 courses,meanwhile anticoagulation with LMWH.After these treatment,the PE all disappeared and their ascites and mass sizes obviously decreased.Furthermore,the 4 patients with PE all got satisfied cytoreductive surgery.The analysis results showed that the differences of thrombus group and non-thrombus group in age,preoperative D-dimer value,platelet count,preoperative chemotherapy,whether patients with cardiovascular disease as well as the operation time.In multivariate analysis,we found that age>55years,tumor diameter>10cm,preoperative PLT>300*109/L and d-dimer value>0.5 ug/ml were independent risk factors of preoperative VTE,while d-dimer value>0.5 ug/ml and surgery time>150 minutes were independent risk factors of postoperative VTE.Conclusions:Positive preoperative screening should be performed before gynecologic surgery,and aggressive precautions should be taken during the perioperative period,especially for patients with high risk VTE.The patients with elder age,huge tumor,and high D-dimer value should be paid high attention to and less surgery time are optimal treatment in preventing VTE.For patients with ovarian cancer who have been diagnosed with thrombosis before surgery,adjuvant chemotherapy and anticoagulant drugs can be used to control the development of thrombosis and cancer.