Tromboprofilaxis en cirugía ginecológica laparoscópica
DOI:
https://doi.org/10.18041/1900-7841/rcslibre.2016v11n1.1392Palabras clave:
Embolismo popular, Laparoscopia, Tromboprofilaxis, Trombosis venosa profundaResumen
Dentro de los eventos tromboembólicos considerados están: la trombosis venosa profunda y el embolismo pulmonar, principales complicaciones que se pueden presentar durante y después de una cirugía ginecológica, por vía abierta o laparoscópica. Existe incertidumbre sobre el riesgo atribuido de tromboembolismo venoso después de procedimientos laparoscópicos, siendo controvertida la recomendación de tromboprofilaxis en este campo. El American College of Chest Physicians y el American Congress of Obstetricians and Gynecologist sugieren la clasificación de riesgo en 4 categorías: bajo, medio, alto y muy alto de las pacientes programadas para cirugía ginecológica. El riesgo de evento tromboembólico va a depender del tipo de procedimiento, tiempo quirúrgico, edad y la presencia de otros factores de riesgo. Hasta tener mayor evidencia, las pacientes llevadas a cirugía laparoscópica deberán ser estratificadas por categoría de riesgo y proveer profilaxis similar a pacientes llevadas a laparotomía. En mujeres de alto riesgo (mayores de 60 años, historia de trombosis venosa profunda, embolismo pulmonar o cáncer) se pueden beneficiar de la profilaxis dual y de prolongar su profilaxis hasta por 28 días.
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Referencias
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4. Nick AM, Schmeler KM, Frumovitz MM, Soliman PT, Spannuth WA, Burzawa JK, et al. Risk of throm- boembolic disease in patients undergoing laparos- copic gynecologic surgery. Gynecol Oncol. 2010116 (4): 956-61. URL disponible en: https://www.ncbi. nlm.nih.gov/pubmed/20859161 DOI: 10.1097/ AOG.0b013e3181f240f7
5. Solomon ER, Frick AC, Paraiso MF, Barber MD. Risk of deep venous thrombosis and pulmonary embo- lism in urogynecologic surgical patients. Am J Obstet Gynecol. 2010; 203 (5): 510.e1-4. URL disponible en: https://www.ncbi.nlm.nih.gov/pubmed/20800214 DOI: 10.1016/j.ajog.2010.07.021
6. Peedicayil A, Weaver A, Li X, Carey E, Cliby W, Mariani A. Incidence and timing of venous throm- boembolism after surgery for gynecological cancer. Gynecol Oncol. 2011; 121 (1): 64-9. URL disponible en: https://www.ncbi.nlm.nih.gov/pubmed/21183211 DOI: 10.1016/j.ygyno.2010.11.038
7. Zhang L, Liu X, Xue Y. Analysis of deep venous thrombosis after gynecological surgery: A clinical study of 498 cases. Pak J Med Sci. 2015; 31 (2): 453-6. URL disponible en: https://www.ncbi.nlm.nih.gov/ pubmed/26101510 DOI: 10.12669/pjms.312.6608
8. Oger E. Incidence of venous thromboembolism: a communitybased study in Western France. EPI-GET- BP Study Group. Groupe d’Etude de la Thrombose de Bretagne Occidentale. Thromb Haemost. 2000; 83 (5): 657-60. URL disponible en: https://www.ncbi. nlm.nih.gov/pubmed/10823257
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11. Anderson FA Jr, Wheeler HB, Goldberg RJ, Hosmer DW, Patwardhan NA, Jovanovic B, et al. A popula- tion-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pul- monary embolism. The Worcester DVT Study. Arch Intern Med. 1991; 151 (5): 933-8. URL disponible en: https://www.ncbi.nlm.nih.gov/pubmed/2025141
12. Qu H, Li Z, Zhai Z, Liu C, Wang S, Guo S, et al. Predicting of venous thromboembolism for patients undergoing gynecological surgery. Medicine (Bal- timore). 2015; 94 (39): e1653. URL disponible en: https://www.ncbi.nlm.nih.gov/pubmed/26426660 DOI: 10.1097/MD.0000000000001653
13. Caprini JA. Thrombosis risk assessment as a guide to quality patient care. Dis Mon. 2005; 51 (2-3): 70-8. https://www.ncbi.nlm.nih.gov/pubmed/15900257 DOI: 10.1016/j.disamonth.2005.02.003
14. Brennand JE, Greer IA. Thromboembolism in gy- naecological surgery. Curr Obst Gynaecol. 1998; 8 (1): 44-8. URL disponible en: https://www.resear- chgate.net/publication/223286768_Thromboem- bolism_in_gynaecological_surgery doi: 10.1016/ S0957–5847(98)80010–3.
15. Virchow R. Die Cellularpathologie in ihrer Be- grindung auf physiologische and pathologische Gewebslehre. Berlin;: 1858. URL disponible en: http://www.deutschestextarchiv.de/book/show/ virchow_cellularpathologie_1858
16. Goldman L, Schafer AI (eds.). Pulmonary embolism. In: Goldman’s Cecil Medicine. 24th ed. Philadelphia: Elsevier Saunders; 2012; pp. 596-602.
18. Mann DL, Zipes DP, Libby P, Bonow RO. eds. Pulmonary embolism. In: Braunwald’s heart disease: a textbook of cardiovascular medicine. 10th ed. Philadel- phia: Elsevier Saunders; 2015. pp. 1664-81.
19. Pérez-Gómez F, Bover R. La nueva cascada de la coagulación y su posible influencia en el difícil equi- librio entre trombosis y hemorragia. Rev Esp Cardiol. 2007; 60 (12): 1217-9. URL disponible: http://www. revespcardiol.org/es/la-nueva-cascada-coagula- cion-su/articulo/13113924/
20. Clark C, Cotton LT. Blood flow in deep veins of legs: recording technique and evaluation of methods to increase flow during operation. Br J Surg. 1968; 55: 211-4.
21. Elisha S, Heiner J, Nagelhout J, Gabot M. Venous thromboembolism: New concepts in perioperative management. AANA J. 2015; 83 (3): 211-21. URL disponible en: https://www.ncbi.nlm.nih.gov/ pubmed/26137764
22. Egan EL, Bowie EJ, Kazmier FJ, Gilchrist GS, Woods JW, Owen CA Jr. Effect of surgical operations on cer- tain tests used to diagnose intravascular coagulation and fibrinolysis. Mayo Clin Proc. 1974; 49: 658-64. URL disponible en: https://www.ncbi.nlm.nih.gov/ pubmed/4413095
23. Piccioli A, Prandoni P, Ewenstein BM. Cancer and venous thromboembolism. Am Hear J. 1996; 132: 850-5.
24. Goad KE, Gralnick HR. Coagulation disorders in cancer. Hematol Oncol Clin North Am. 1996; 10 (2): 457-84. URL disponible: https://www.ncbi.nlm.nih. gov/pubmed/8707764
25. Walker JL, Piedmonte MR, Spirtos NM, Eisenkop SM, Schlaerth JB, Mannel RS, et al.. Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group Study LAP2. J Clin Oncol. 2009; 27 (32): 5331-6. URL disponible en: https://www. ncbi.nlm.nih.gov/pubmed/19805679 DOI: 10.1200/ JCO.2009.22.3248
26. Zhang H, Cui J, Jia L, Hong S, Kong B, Dadong L. Comparison of laparoscopy and laparotomy for endometrial cancer. Int J Gynaecol Obstetr. 2012; 116 (3): 185-91.
27. Nguyen NT, Hinojosa MW, Fayad C, Varela E, Konyalian V, Stamos MJ, et al. Laparoscopic sur- gery is associated with a lower incidence of venous thromboembolism compared with open surgery. Ann Surg. 2007; 246 (6): 1021-7. URL disponible en: https://www.ncbi.nlm.nih.gov/pubmed/18043105 DOI: 10.1097/SLA.0b013e31815792d8
28. Feng L, Song J, Wong F, Xia E. Incidence of deep venous thrombosis after gynaecological laparos- copy. Chin Med J (Engl). 2001; 114 (6): 632-5. URL disponible en: https://www.ncbi.nlm.nih.gov/ pubmed/11780442
29. Clarke-Pearson DL, Synan IS, CreasmanWT. Signi- ficant venous thromboembolism caused by pelvic lymphocysts: diagnosis and management. Gynecol Oncol. 1982; 13 (1): 136-43. URL disponible en: https://www.ncbi.nlm.nih.gov/pubmed/7060988
30. Goldhaber SZ, Fanikos J. Prevention of deep vein thrombosis and pulmonary embolism. Am Coll Obstet Gynecol Obs Gynecol. 2007; 110: 429-40.
31. Clarke-Pearson DL, Dodge RK, Synan I MR, GL. M. Venous thromboembolism prophylaxis: patients at high risk to fail intermittent pneumatic com- pression. Obstet Gynecol. 2003; 101 (1):157-63. URL disponible en: https://www.ncbi.nlm.nih.gov/ pubmed/12517661
32. Ageno W, Manfredi E, Dentali F, Silingardi M, Ghez- zi F, Camporese G, et al. The incidence of venous thromboembolism following gynecologic laparosco- py: a multicenter, prospective cohort study. J Thromb Haemost. 2007; 5 (3): 503-6.
33. Healey MG, Maher PJ, Hill DJ, Meagher SE, Tregas- kis-Lye LE. The risk of venous thrombosis following gynaecological laparoscopic surgery. Med J Aust. 1998; 168 (10): 524. URL disponible en: https:// www.ncbi.nlm.nih.gov/pubmed/9631681
34. Lyman GH, Khorana AA, Kuderer NM, Lee AY, Ar- celus JI, Balaban EP, et al. Venous thromboembolism prophylaxis and treatment in patients with cancer: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol. 2013; 31 (17): 2189-204. URL disponible en: http://ascopubs.org/ doi/full/10.1200/jco.2013.49.1118 DOI: 10.1200/ JCO.2013.49.1118
35. Clarke-Pearson DL, Synan IS, Colemen RE, Hinshaw W, Creasman WT. The natural history of postopera- tive venous thromboemboli in gynecologic oncology: a prospective study of 382 patients. Am J Obstet Gynecol. 1984; 148 (8): 1051-4. URL disponible en: https://www.ncbi.nlm.nih.gov/pubmed/6711637
36. Kakkar VV, Howe CT, Flanc C, Clarke MB. Natural history of postoperative deep-vein thrombosis. Lan- cet. 1969; 2 (7614): 230-2. URL disponible en: https:// www.ncbi.nlm.nih.gov/pubmed/4184105
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2016-06-01
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Artículos de revisión
Cómo citar
Narváez Ortega, G. J. (2016). Tromboprofilaxis en cirugía ginecológica laparoscópica. Revista Colombiana Salud Libre, 11(1), 102-110. https://doi.org/10.18041/1900-7841/rcslibre.2016v11n1.1392
