|
|
|
|
|
|
|
|
abstract
Objective
Ovarian
vein thrombosis is associated with pregnancy and pelvic surgery.
Postpartum ovarian vein thrombosis is associated with infection and a
high morbidity rate and is treated with anticoagulant and intravenous
antibiotic therapy. The natural history of such thrombotic events after
debulking surgery for ovarian cancer has not been well described. Our
objective was to characterize the presentation and outcomes for patients
with this condition at our institution.
Study Design
We
conducted a retrospective study of patients who underwent surgical
debulking for ovarian cancer at Memorial Sloan Kettering Cancer Center
between the years 2001 and 2010. Patients were included if contrast
computed tomography scans of both the abdomen and pelvis were performed
within 12 weeks before and 12 weeks after the surgery. The images were
reviewed to assess for the presence and extent of a new postoperative
ovarian vein thrombosis. When available, subsequent studies were
assessed for thrombus progression. Medical records were reviewed to
determine whether anticoagulation was used for treatment of the
thrombotic episode and to record the occurrence of any new significant
venous thromboembolic event in the next year.
Results
One
hundred fifty-nine patients had satisfactory imaging. New ovarian vein
thrombosis was a common complication of debulking surgery, as found in
41 of patients (25.8%). Only 5 women with ovarian vein thrombosis were
started on anticoagulation, of which 2 individuals had an independent
venous thromboembolic event as indication for treatment. Only 2 of the
ovarian vein thromboses (4.9%) progressed to the inferior vena cava or
left renal vein on subsequent scan. The estimated cumulative incidence
of venous thromboembolism 1 year after the first postoperative scan was
17.1% for patients in the new ovarian vein thrombosis group vs 15.3% of
individuals for the group without a postoperative ovarian vein
thrombosis (P = .78).
Conclusion
Ovarian
vein thrombosis is commonly encountered after debulking surgery for
ovarian cancer. Anticoagulation is usually not indicated, and clinically
meaningful thrombus progression rarely occurs.
0 comments :
Post a Comment
Your comments?
Note: Only a member of this blog may post a comment.