Lethal thromboembolism and its prevention in pelvic surgery: A review

Five hundred thousand new cases of pulmonary embolism occur annually in the United States and at least 10% of these are fatal. A survey of the members of the Felix Rutledge Society reveals that 84.5% of its members use low-dose heparin prophylactically in high-risk patients. The data supporting the efficacy of thromboembolism prophylaxis are reviewed. Four possible reasons why low-dose heparin is not used by all pelvic surgeons are discussed. The conclusion is that despite hazards in its use, the burden now rests with the gynecologic oncologist who does not use this prophylactic treatment to show cause for its omission.