Blood Res.  2020 Mar;55(1):44-48. 10.5045/br.2020.55.1.44.

Thromboprophylaxis after bariatric surgery

Affiliations
  • 1Department of Internal Medicine, College of Medicine, Shaqra University, Shaqra, Arabia. feras-mmm@hotmail.com
  • 2College of Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, Arabia.
  • 3Department of Medicine, King Fahd Hospital, Jeddah, Arabia.
  • 4College of Medicine, King Saud University, Riyadh, Saudi Arabia.
  • 5Sultan Qaboos University, Sultan Qaboos University Hospital, Oman.

Abstract

BACKGROUND
Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is a known cause of morbidity and mortality after bariatric surgery. However, the data concerning appropriate thromboprophylaxis after bariatric surgery is uncertain. The objective of this study was to evaluate the efficacy and safety of extended duration thromboprophylaxis in post-bariatric surgery patients.
METHODS
We conducted a retrospective study of consecutive patients who underwent bariatric surgery from November 2014 to October 2018 at King Fahad General Hospital in Jeddah, Saudi Arabia. All included patients were treated with extended duration thromboprophylaxis.
RESULTS
We identified 374 patients who underwent bariatric surgery during the study period. Of these, 312 patients (83%) were followed for at least 3 months. The most common type of surgery was a laparoscopic sleeve gastrectomy (N=357) and the median weight was 110 kg. The cumulative incidence of symptomatic postoperative VTE at 3 months was 0.64% (95% confidence interval, 0.20-1.52). All events occurred after hospital discharge. The most commonly used pharmacological prophylaxis (91%) for VTE prevention after bariatric surgery was enoxaparin 40 mg subcutaneously twice daily for 10-14 days after hospital discharge. There were no reported cases of bleeding or VTE related mortality after 3 months.
CONCLUSION
Extended thromboprophylaxis after bariatric surgery appears to be an effective and safe strategy for VTE prevention. Large prospective studies are needed to evaluate the optimal thromboprophylaxis regimen after bariatric surgery.

Keyword

Thromboprophylaxis; Pulmonary embolism; Deep vein thrombosis; Venous thromboembolism; Bariatric surgery

MeSH Terms

Bariatric Surgery*
Enoxaparin
Gastrectomy
Hemorrhage
Hospitals, General
Humans
Incidence
Mortality
Prospective Studies
Pulmonary Embolism
Retrospective Studies
Saudi Arabia
Venous Thromboembolism
Venous Thrombosis
Enoxaparin
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