Abstract
We sought to comprehensively assess the efficacy of Intermittent Pneumatic Compression (IPC) in patients undergoing gynecologic surgery. A computerized literature search was conducted in Pubmed, Embase and Cochrane Library databases. Seven randomized controlled trials involving 1001 participants were included. Compared with control, IPC significantly lowered the deep vein thrombosis (DVT) risk [risk ratio (RR) = 0.33, 95% confidence interval (CI): 0.16 – 0.66]. The incidence of DVT in IPC and drugs group was similar (4.5% versus. 3.99%, RR = 1.19, 95% CI: 0.42 – 3.44). With regards to pulmonary embolism risk, no significant difference was observed in IPC versus control or IPC versus drugs. IPC had a lower postoperative transfusion rate than heparin (RR = 0.53, 95% CI: 0.32 – 0.89), but had a similar transfusion rate in operating room to low molecular weight heparin (RR = 1.06, 95% CI: 0.69 – 1.63). Combined use of IPC and graduated compression stockings (GCS) had a marginally lower risk of DVT than GCS alone (RR = 0.38, 95% CI: 0.14 – 1.03). In summary, IPC is effective in reducing DVT complications in gynecologic surgery. IPC is neither superior nor inferior to pharmacological thromboprophylaxis. However, whether combination of IPC and chemoprophylaxis is more effective than IPC or chemoprophylaxis alone remains unknown in this patient population.
Highlights
The incidence of venous thromboembolism (VTE) is more than 100 persons per 100000, and increases with advancing age [1]
The study by Gao et al compared a combination of Intermittent Pneumatic Compression (IPC) and graduated compression stockings (GCS) with GCS alone, and considered two lower limbs as two samples when calculating deep vein thrombosis (DVT) rate [17]
Without VTE prophylaxis, reported postoperative incidence of DVT was as high as 37.9% in patients with gynecologic cancer [19]
Summary
The incidence of venous thromboembolism (VTE) is more than 100 persons per 100000, and increases with advancing age [1]. The morbidity and mortality of VTE remain high despite the improved prophylaxis, due to various risk factors, such as surgery, trauma, malignancy, hospital, increasing age, lower extremity paresis and so on [2]. Pulmonary embolism (PE) and deep vein thrombosis (DVT) are two main manifestations of symptomatic VTE. There is an increased risk of VTE in perioperative patients. It was reported that there was averagely an incidence of symptomatic VTE of 0.8% within 3 months after operation, and up to 3% in high-risk procedures [3]. Taking into account the fact that approximately 50% of DVT are silent [4], the true frequency of postoperative VTE may even much higher
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
