A New Protocol for Venous Thromboembolism Prophylaxis in Bariatric Surgery
Hacı Hasan Abuoglu1, M A Tolga Müftüoğlu2, Mehmet Odabaşı2
1Haydarpaşa Numune Training and Research Hospital General Surgery Clinic, Tıbbiye Cad. No. 23, 34668, Üsküdar/İstanbul, Turkey. abuoglu@gmail.com.
Obesity Surgery
|December 14, 2018
Summary
This study found that a new protocol using low-dose low-molecular-weight heparin (LMWH) and pneumatic compression devices (PCD) effectively prevented venous thromboembolism (VTE) in patients undergoing bariatric surgery. No VTE events occurred, demonstrating the protocol
Area of Science:
- Bariatric surgery outcomes
- Venous thromboembolism (VTE) prophylaxis
- Obesity medicine
Background:
- Morbidly obese patients face a high risk of venous thromboembolism (VTE).
- Existing VTE prophylaxis strategies require evaluation in the context of bariatric surgery.
- Novel protocols combining pharmacological and mechanical methods are being explored.
Purpose of the Study:
- To assess the efficacy of a novel VTE prophylaxis protocol in patients undergoing bariatric surgery.
- To evaluate the combined effect of low-dose low-molecular-weight heparin (LMWH) and pneumatic compression devices (PCD).
- To determine the safety and effectiveness of this protocol in a high-risk obese population.
Main Methods:
- A cohort of 368 morbidly obese patients undergoing bariatric surgery between November 2015 and December 2017.
- Preoperative administration of low-dose nadroparin (LMWH), followed by intraoperative and 24-hour postoperative application of a pneumatic compression device (PCD).
- Postoperative LMWH continuation for 15 days, early ambulation encouragement, and regular follow-up.
Main Results:
- Zero instances of VTE were recorded during the postoperative period or at 1-, 3-, and 6-month follow-ups.
- Four cases of bleeding occurred, necessitating transfusions but not re-laparotomy.
- A 0% mortality rate was observed at 30 and 90 days, as well as during hospitalization.
Conclusions:
- The combined use of low-dose LMWH and PCD is a highly effective strategy for VTE prophylaxis in bariatric surgery patients.
- This protocol demonstrates a favorable safety profile with minimal bleeding complications.
- The findings support the implementation of this combined approach to reduce VTE risk in this vulnerable patient group.
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