Objective  To assess the venous thromboembolism (VTE) risk and evaluate the effectiveness of combined physical exercise and intermittent pneumatic compression device treatment in thromboprophylaxis among peritoneal carcinomatosis (PC) patients treated by cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).

  Methods  A total of 120 CRS+HIPEC procedures were performed on 120 consecutive patients with PC from gastrointestinal and gynecological malignancies. The Caprini risk factor score was adopted to evaluate the VTE risk for each patient. For VTE prevention, a systematic physiotherapy program comprising active exercises of both arms and legs, as well as intermittent pneumatic compression device treatment, was developed. This physiotherapy was applied to all patients, and the VTE-related events were recorded and analyzed.

  Results  The median Caprini risk factor score was 12 (range, 10-16); all patients were at the highest VTE risk. The systematic physiotherapy program was applied to all patients during the perioperative period, and no clinically symptomatic VTE events were observed during the hospitalization treatment after operation. During the 3-month follow-up period, only 1 of the 120 patients developed right-leg deep-vein thrombosis, which was cured after drug treatment.

  Conclusion  PC patients treated by CRS + HIPEC are at the highest risk for VTE. The systematic physiotherapy program can effectively prevent VTE in such patients.