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The most common adverse outcomes of gynecologic surgery are hemorrhage, infection, and venous thromboembolism (VTE); but does surgical route matter? To assess risk for VTE after laparotomy, laparoscopy, or vaginal gynecologic surgery, investigators conducted a retrospective study of 43,751 gynecologic surgeries at two academic medical centers.
For hysterectomy, postoperative VTE incidence was 1.0% (laparotomy), 0.3% (laparoscopy), and 0.1% (vaginal). Among women with cancer, the VTE incidence was 2.2% (laparotomy), 0.7%, (laparoscopy), and 0.0% (vaginal); among those without cancer, incidence was 0.6%, 0.2%, and 0.1%. In all, 91% of women who developed a postoperative VTE had received thromboprophylaxis (mechanical, pharmacologic, or both) b…