[Prophylaxis of thromboembolic complications in patients, operated on for alimentary-constitutional obesity]

Results of laparoscopic and open bariatric opeartions, made in 2 3 patients for alimentary-constitutional obesity (ACO) were analyzed. Restrictive gastroshunting was applied in 19 patients, biliopancreatic shunting according to N. Scopinaro method--in 4, gastric banding using special gastric rings--in 220. Practically in all the patients the consistent leaning was achieved. The efficacy of nonfractionized heparin and low-molecular heparin (Fraxiparine) application for prophylaxis of thromboembolic complications (THEC) was studied up in operated patients. According to our data obtained, in the group, consisting of 118 patients, in whom heparin was applied for the THEC prophylaxis, the rate of specific complications occurrence was in 7 times higher than in group of 113 patients, in whom Fraxiparine was applied for the THEC prophylaxis. While performing reoperations in patients, to whom Fraxiparine was administered in primary operation conduction for prophylaxis, the lower rate of adhesions in abdominal cavity or its absence was noted, comparing with such in group of patients, to whom Fraxiparine during first operation was not administered. Our experience witnesses that application of Fraxiparine during performance of bariatric operative interventions constitutes obligatory condition of successful management of patients suffering ACO in postoperative period, secures essential lowering of the THEC occurrence risk and reduces the adhesions formation in abdominal cavity.