A New Protocol for Venous Thromboembolism Prophylaxis in Bariatric Surgery
Morbidly obese patients are at high risk for developing venous thromboembolism (VTE). The aim of this study was to evaluate the effect of a new VTE prophylaxis protocol (low dosage, low-molecular-weight heparin [LMWH]) with a pneumatic compression device (PCD) in patients undergoing bariatric surgery.
Materials and Methods
Between November 2015 and December 2017, 368 patients underwent surgery due to obesity. The patients received 0.2 ml of nadroparin (Fraxiparine, GlaxoSmithKline) 12 h before the operation. A PCD (Kendall SCD Compression System) was applied to the patient during the operation and left on the patient during the subsequent 24 h. Nadroparin 0.4 ml was started subcutaneously after the PCD was removed from the patient and the same dosage of nadroparin was given daily for 15 days following the bariatric operation. Ambulation within 2 h of surgery was encouraged and was performed frequently.
A total of 368 patients underwent laparoscopic bariatric surgery. The median age was 34.1 years (range, 18–61), the median weight was 128 kg (range, 90–182), and the median body mass index (BMI) was 47.2 kg/m2 (range, 36–72). No thrombotic events were observed postoperatively or at the 1-, 3-, and 6-month follow-up visits. Four bleedings occurred requiring transfusions. None of these patients required a re-laparotomy for hemorrhage control. The mortality rate was 0% at 30 and 90 days and during the hospitalization.
Low dosage LMWH with PCD is very effective for VTE prophylaxis in bariatric surgery.
KeywordsBariatric surgery Venous thromboembolism Chemoprevention Hemorrhage
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Studies with Human Participants
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
An approval from the local ethics committee of Haydarpaşa Numune Training and Research Hospital (HNTARH) was obtained for this study, and written informed consent was obtained in accordance with the Declaration of Helsinki from all patients. Privacy rights of the patients have been observed.
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