Effect of Intermittent Pneumatic Compression Device on Coagulation and Fibrinolysis and Distal Deep Venous Thromboembolism in Patients Undergoing Gynaecology Laparoscopic Surgery During Perioperative Care: A Retrospective Cohort Study

间歇性气动加压装置对接受妇科腹腔镜手术患者围手术期凝血、纤溶及远端深静脉血栓栓塞的影响:一项回顾性队列研究

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Abstract

BACKGROUND AND AIM: Most studies focus on preventing deep-vein thromboembolism (DVT) in gynecologic malignancy patients, while peri/postoperative hemostatic disorders in benign gynecologic conditions are understudied. This study evaluated if sequential pneumatic compression (IPC) modulates coagulation, fibrinolysis, and DVT incidence in benign-condition patients undergoing minimally invasive laparoscopic surgery. METHODS: A retrospective cohort study (Jan 2021-Aug 2022) at the Second Affiliated Hospital of Guangzhou University of Chinese Medicine enrolled adult Chinese women with benign gynecologic disorders who had laparoscopic surgery. Patients were divided into IPC (used compression sleeves intraoperatively/early postoperatively) and no-IPC groups. Hemostatic indices (PT, INR, APTT, FIB, DDi, FDP) and DVT (monitored clinically, confirmed via duplex ultrasonography) were recorded. GraphPad Prism 8.0 was used for statistics (paired t-tests, Mann-Whitney tests; p<0.05=significant). RESULTS: 119 patients were included (IPC: 62; no-IPC: 57). Both groups had significant postoperative changes in PT, INR, DDi, FDP, PT% and TT (p<0.001). The IPC group showed better pre-/postoperative ratios of PT, INR and FDP vs the no-IPC group (p<0.05), but DVT incidence was similar (3.2% vs 3.3%), with all cases being distal calf DVT. CONCLUSION: Distal DVT incidence is low in benign gynecologic surgery patients. IPC regulates surgery-induced coagulation/fibrinolysis activation, aiding peri/postoperative prevention.

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