Clinical Research Papers:
Efficacy of intermittent pneumatic compression for venous thromboembolism prophylaxis in patients undergoing gynecologic surgery: A systematic review and meta-analysis
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Jian-Ping Feng1, Yu-Ting Xiong2, Zi-Qi Fan1, Li-Jie Yan1, Jing-Yun Wang1, Ze-Juan Gu3
1Department of Anesthesiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
2Department of Nursing, The Second Affiliated Hospital of Wannan Medical College, Wuhu 241000, Anhui Province, China
3Department of Nursing, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Ze-Juan Gu, email: [email protected]
Keywords: gynecologic surgery, pulmonary embolism, deep vein thrombosis, intermittent pneumatic compression, heparin
Received: August 08, 2016 Accepted: November 07, 2016 Published: November 25, 2016
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.
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