Extended thromboprophylaxis reduces incidence of postoperative venous thromboembolism in laparoscopic bariatric surgery

Conor J Magee, Jonathan Barry, Shafiq Javed, Robert Macadam, David Kerrigan
Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery 2010, 6 (3): 322-5

BACKGROUND: Venous thromboembolism (VTE) after laparoscopic bariatric surgery is a significant cause of morbidity and mortality. The objective of the present study was to study the incidence of symptomatic VTE in extended thromboprophylaxis regimens using dalteparin at an independent hospital in England, United Kingdom.

METHODS: A prospective database of all patients undergoing bariatric surgery was retrospectively analyzed. All patients underwent VTE prophylaxis regimen using perioperative and extended postoperative low-molecular-weight heparin (dalteparin 2500 IU preoperatively, followed by 5000 IU daily postoperatively). The treatment period was 1 week for laparoscopic gastric banding or 3 weeks for all other procedures. Inferior vena cava filters were used in selected patients with thrombophilia, a history of pulmonary embolism, or >1 episode of deep vein thrombosis. The endpoint was the incidence of symptomatic VTE.

RESULTS: A total of 735 patients underwent laparoscopic bariatric surgery, all of whom received dalteparin. The postoperative VTE incidence was 0%. The 30-day and 90-day all-cause mortality rate was 0%. A total of 3 adverse bleeding events occurred.

CONCLUSION: An extended VTE prophylaxis regimen using low-molecular-weight heparin is simple and effective and was associated with a low incidence of bleeding complications.

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