The risk factors for perioperative venous thromboembolism in patients with gynecological malignancies: A meta-analysis

Objective This meta-analysis aimed to identify the risk factors for venous thromboembolism (VTE) in patients with gynecological malignancy during the perioperative period. Methods Studies on the risk factors for VTE in patients with gynecological malignancy during the perioperative period were collected from the Cochrane Library, MEDLINE, EMBASE, Web of Science, EBSCO, and several Chinese databases (from inception to September 2019). Two reviewers independently performed article screening, data extraction, and study quality evaluation. Review Manager 5.3 software was used for data analysis. Results A total of 9555 articles were initially retrieved, including 7498 in Chinese and 1987 in English, and 22 articles were finally included, which were published from 2011 to 2019. The quality scores of the included studies ranged from 5 to 9, suggesting a relatively high quality. A total of 16,318 patients were included for analysis, 922 in the VTE group and 15,396 in the non-VTE group. A total of 20 risk factors related to surgery or with inconsistent conclusions in the current studies were pooled, and the results showed that age, body mass index (BMI > 26 kg/m2), platelet count, D-dimer, duration of surgery, postoperative days in bed, length of hospital stay, intraoperative blood loss, tumor differentiation (GREAD3), tumor staging (stage IV), and operative approach (laparotomy versus laparoscopy) were significant risk factors for VTE in patients with gynecological malignancy during the perioperative period. Conclusion It is important to develop targeted prevention and treatment strategies against these risk factors to reduce the occurrence of VTE in patients with gynecological malignancy during the perioperative period.