A Systematic Review and Meta-Analysis on the Use of Rivaroxaban as Thromboprophylaxis Following Bariatric Surgery

Bariatric surgery and obesity increase VTE risk. While VTE incidence after bariatric surgery is low, it impacts morbidity and 30-day mortality. The lack of consensus on the optimal thromboprophylaxis has driven research into alternatives like DOACs. The objective of this study is to determine the efficacy and safety of rivaroxaban as thromboprophylaxis after bariatric surgery and the most effective thromboprophylaxis strategy. Findings from the nine included studies show that rivaroxaban is as effective as controls for DVT/PE prevention, with no PMVT cases. The incidence of minor and major bleeding requiring transfusion are more common with rivaroxaban however the meta-analysis does not consider this as significant evidence against its use. In the subgroup analysis, no significant differences are observed between long- and short-course rivaroxaban regimens across all primary outcomes, though shorter courses showed fewer bleeding complications.