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Randomized Controlled Trial
. 2021 Jan;45(1):126-131.
doi: 10.1007/s00268-020-05782-x. Epub 2020 Sep 28.

Adding a Preoperative Dose of LMWH may Decrease VTE Following Bariatric Surgery

Ahmed Mohammed Abdelsalam  1 , Ahmed Mohammed Salah Eldeen ElAnsary  2 , Mohammed Abdallah Salman  2 , Sahar Abdelrahman Nassef  2 , Hala Mostafa Elfergany  2 , Hesham Ahmed Abou Aisha  2
Affiliations
Randomized Controlled Trial

Adding a Preoperative Dose of LMWH may Decrease VTE Following Bariatric Surgery

Ahmed Mohammed Abdelsalam et al. World J Surg. 2021 Jan.

Abstract

Background: Bariatric procedures are the most effective management for obesity. There is no standard venous thromboembolism (VTE) prophylaxis for both dosing and duration of anticoagulation following laparoscopic sleeve gastrectomy. Our purpose was to assess the optimum regimen for VTE prophylaxis in bariatric procedures and to reduce the incidence of perioperative bleeding.

Methods and materials: This is a prospective randomized study which involved 100 morbidly obese patients, subdivided into two groups; group A received postoperative low molecular weight heparin (LMWH) prophylaxis alone starting from day 1 to day 15 in dose 1 mg/kg/day in a maximum dose 120 mg/day, and group B received both pre- and postoperative LMWH; at night of surgery 12 h preoperatively and postoperative starting from day 1 to day 15 with the same dose. All patients underwent mesenteric and bilateral lower limbs duplex 15 days postoperative using Philips iU machine and linear (L9-3), convex (C5-1) and sector (S5-1) probes.

Results: Regarding postoperative VTE, we found statistically significant increase in postoperative VTE in patients of group A (four cases) without any case complicated with VTE in patients of group B (P value = 0.041). Regarding postoperative bleeding, we found statistically insignificant percent of cases complicated with postoperative bleeding in group B compared to group A (P value 0.315).

Conclusion: Preoperative as well as a postoperative prophylactic anticoagulant as LMWH is recommended to prevent perioperative VTE. There was an insignificant increase in postoperative bleeding in patients who received preoperative prophylactic anticoagulants.

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References

    1. Stein PD, Matta F (2013) Pulmonary embolism and deep venous thrombosis following bariatricsurgery. Obes Surg 23(5):663–668. https://doi.org/10.1007/s11695-012-0854-2 - DOI - PubMed
    1. Schauer PR, Schirmer B (2015) The surgical management of obesity. Schwartz’s principles of surgery, 10th edn. McGrow-Hill Education, New York, pp 1099–1105
    1. Gloy VL, Briel M, Bhatt DL et al (2013) Bariatric surgery versus non-surgical treatment forobesity: a systematic review and meta-analysis of randomised controlled trials. BMJ 347:f5934. https://doi.org/10.1136/bmj.f5934 - DOI - PubMed - PMC
    1. Sjostrom L (2013) Review of the key results from the Swedish Obese Subjects (SOS) trial: a prospective controlled intervention study of bariatric surgery. J Intern Med 273:219–234. https://doi.org/10.1111/joim.12012 - DOI - PubMed
    1. Buchwald DM, Oien H (2013) Metabolic/bariatric surgery worldwide 2011. Obes Surg 23:427–436. https://doi.org/10.1007/s11695-012-0864-0 - DOI - PubMed

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