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

• Published in: World journal of surgery Vol. 45; no. 1; pp. 126 - 131
• Main Authors: Abdelsalam, Ahmed Mohammed, ElAnsary, Ahmed Mohammed Salah Eldeen, Salman, Mohammed Abdallah, Nassef, Sahar Abdelrahman, Elfergany, Hala Mostafa, Aisha, Hesham Ahmed Abou
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 2021; Springer Nature B.V
• Subjects: Abdominal Surgery; Anticoagulants; Bleeding; Cardiac Surgery; Dosage; Gastrectomy; Gastrointestinal surgery; General Surgery; Heparin; Laparoscopy; Low molecular weights; Medicine; Medicine & Public Health; Molecular weight; Obesity; Original Scientific Report; Prophylaxis; Statistical analysis; Surgery; Thoracic Surgery; Thromboembolism; Vascular Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-020-05782-x

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.