30-Day Post-Discharge Prophylaxis with Rivaroxaban Prevents Porto-mesenteric Venous Thrombosis Following Laparoscopic...

Area of Science:

• Bariatric Surgery
• Vascular Surgery
• Pharmacology

Background:

• Porto-mesenteric venous thrombosis (PMVT) is a serious complication more common after laparoscopic sleeve gastrectomy (SG) than other bariatric surgeries.
• PMVT often occurs later postoperatively (around 2 weeks) compared to other venous thromboembolic (VTE) events.
• Standard perioperative chemoprophylaxis may be insufficient for preventing PMVT after SG.

Purpose of the Study:

• To evaluate the efficacy and safety of a 30-day post-discharge chemoprophylaxis (PDC) regimen using rivaroxaban 10 mg daily in reducing PMVT incidence following SG.
• To determine if extended chemoprophylaxis can mitigate the risk of PMVT in patients undergoing SG.

Main Methods:

• A retrospective cohort study involving 292 patients who underwent SG.
• Patients were divided into two groups: Group A received 30-day PDC with rivaroxaban 10 mg daily post-discharge; Group B received no PDC.
• Primary outcome was PMVT; secondary outcome was bleeding. Patients on chronic anticoagulation were excluded.

Main Results:

• A statistically significant reduction in PMVT was observed in Group A (0 events) compared to Group B (4 events, p=0.045).
• The incidence of bleeding events was not significantly different between the groups (4 events in Group A vs. 7 events in Group B, p=0.341).

Conclusions:

• A 30-day post-discharge chemoprophylaxis regimen with rivaroxaban 10 mg daily is a safe and effective strategy for preventing PMVT after SG.
• This extended prophylaxis regimen significantly reduces PMVT risk without a corresponding increase in bleeding complications.