**1. Introduction**

172 Deep Vein Thrombosis

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Deep venous thrombosis or DVT is a blood clot formation in one or more of the deep veins. The blood clot does not break down and therefore, it can become larger and occlude the blood flow within the affected vein. The most frequent sites are the leg veins (femoral and popliteal) and the deep pelvic veins. Rarely, the arm veins are affected (Paget-Schrötter disease). Pulmonary embolism (PE) is the most dangerous complication of DVT. PE occurs when the clot breaks into small pieces (emboli) and travel to the lung. The embolus may travel to other vital organs and cause life-threatening complications such as stroke or heart attack.

The etiology of thrombosis is exactly unknown, however, the Virchow's triad of slow circulation (stasis), increased blood coagulability and vessel wall intimal injury is the alleged mechanism.

DVT and PE developing after trauma and pelvic surgery are of a major concern to surgeons of all subspecialties. Therefore, proper assessment of the patient risk to develop DVT is of paramount importance. The risk of DVT can be decreased significantly by adopting some appropriate prophylactic procedures.

Although adopting anti-DVT prophylactic measures is not debatable, the use of these measures has not yet been a universal issue, even in patients having no contraindications to their use.

In this chapter, the term "radical pelvic surgeries" mean all types of major surgeries performed to treat malignancies developing in the pelvis, such as radical cystectomy, salvage cystectomy, radical prostatectomy, radical or pan-hysterectomy, radical surgery for colo-rectal cancer and excision of a local tumor recurrence after primary radical surgery or after definitive radiotherapy
