静脉血栓栓塞是妇科癌症手术的一种可预防的并发症，可导致术后发病率和死亡率。本研究比较了阿哌沙班和依诺肝素，以确定阿哌沙班对于接受妇科癌症手术的患者是否具有相同的安全性和有效性。该研究确定了在 2020 年 6 月至 2023 年 4 月期间接受手术并出院时服用阿哌沙班的妇科恶性肿瘤患者。疾病10代码用于识别术后90天内发生血栓栓塞或术后60天内发生出血事件的患者。将服用阿哌沙班的患者的事件发生率与接受依诺肝素的历史队列患者的事件发生率进行比较。 Fisher 精确检验用于比较分类变量，t 检验用于比较连续变量。进行逻辑回归来比较两组之间血栓栓塞的几率。患者的基线特征在体重指数（BMI）、种族、手术途径和癌症类型方面存在差异。在阿哌沙班队列的 490 名患者中，有 12 名患者 (2.4%) 出现血栓栓塞，而依诺肝素组的 138 名患者中有 3 名患者 (2.1%) 出现血栓栓塞（调整后比值比 [aOR]，1.02；95% 置信区间 [CI] 0.30 -4.70；p > 0.999）。根据 BMI、年龄和手术途径调整优势比。阿哌沙班组 490 例患者中有 1 例（0.2%）发生出血事件，依诺肝素组 138 例患者中有 1 例（0.7%）发生出血事件。这项验证研究表明，阿哌沙班是一种安全有效的术后静脉血栓栓塞治疗方法预防。这些数据为之前的数据和指南更新提供了支持，建议使用阿哌沙班进行术后预防。© 2024。外科肿瘤学会。

Venous thromboembolism is a preventable complication of gynecologic cancer surgery that leads to postoperative morbidity and mortality. This study compared apixaban with enoxaparin to identify whether apixaban had the same safety and efficacy for patients undergoing gynecologic cancer surgery.The study identified patients with a gynecologic malignancy who underwent surgery and were prescribed apixaban at discharge between June 2020 and April 2023. International Classification of Diseases 10 codes were used to identify patients who had a thromboembolism within 90 days or a bleeding event within 60 days after surgery. The rates of events for patients prescribed apixaban were compared with those for a historical cohort of patients who received enoxaparin. Fisher's exact tests were used to compare categorical variables, and t tests were used to compare continuous variables. A logistic regression was performed to compare the odds of thromboembolism between the two groups.Baseline patient characteristics differed in terms of body mass index (BMI), race, route of surgery, and type of cancer. Of the 490 patients in the apixaban cohort, 12 (2.4%) had a thromboembolism compared with 3 (2.1%) of the 138 patients in the enoxaparin group (adjusted odds ratio [aOR], 1.02; 95% confidence interval [CI] 0.30-4.70; p > 0.999). The odds ratio was adjusted for BMI, age, and route of surgery. A bleeding event occurred for 1 (0.2%) of the 490 patients in the apixaban group and for 1 (0.7%) of the 138 patients in the enoxaparin group.This validation study showed that apixaban is a safe and effective method of postoperative venous thromboembolism prophylaxis. The data provide support to previous data and guideline updates recommending the use of apixaban for postoperative prophylaxis.© 2024. Society of Surgical Oncology.