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Thromboprophylaxis after bariatric surgery.
Feras M Almarshad1, Mosaad Almegren2, Turki Alshuaibi3
1Department of Internal Medicine, College of Medicine, Shaqra University, Shaqra, Arabia.
Blood Research
|April 10, 2020
Summary
Extended thromboprophylaxis effectively prevents venous thromboembolism (VTE) after bariatric surgery. This strategy showed a low VTE incidence and no related mortality or bleeding events in post-operative patients.
Area of Science:
- Bariatric Surgery Outcomes
- Thromboprophylaxis Efficacy
- Venous Thromboembolism (VTE) Prevention
Background:
- Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), is a significant cause of morbidity and mortality following bariatric surgery.
- Current data on optimal thromboprophylaxis strategies post-bariatric surgery remains uncertain, necessitating further investigation.
Purpose of the Study:
- To evaluate the efficacy and safety of extended duration thromboprophylaxis in patients undergoing bariatric surgery.
- To assess the incidence of symptomatic VTE and related complications within 3 months post-surgery.
Main Methods:
- Retrospective study of 374 patients who underwent bariatric surgery between November 2014 and October 2018.
- All patients received extended duration thromboprophylaxis, primarily enoxaparin 40 mg twice daily for 10-14 days post-discharge.
- Follow-up for at least 3 months was conducted for 312 patients (83%).
Main Results:
- The cumulative incidence of symptomatic VTE at 3 months was low at 0.64% (95% CI, 0.20-1.52), with all events occurring after hospital discharge.
- Laparoscopic sleeve gastrectomy was the most common procedure (N=357), with a median patient weight of 110 kg.
- No cases of bleeding or VTE-related mortality were reported within the 3-month follow-up period.
Conclusions:
- Extended thromboprophylaxis is a safe and effective approach for preventing VTE in the post-bariatric surgery population.
- Further large-scale prospective studies are required to determine the optimal thromboprophylaxis regimen for these patients.
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