M Todd Miller1, Peter F Rovito. 1. Department of Surgery, Lehigh Valley Hospital, Cedar Crest and I-78, Allentown, PA 18105, USA.
Abstract
BACKGROUND: Venous thromboembolism (VTE) prophylaxis regimens for laparoscopic Roux-en-Y gastric bypass (LRYGBP) have not been adequately addressed in the literature. This study presents the results of our prophylactic regimen in LRYGBP at a tertiary care hospital. METHODS: A retrospective review of 255 morbidly obese patients undergoing LRYGBP between March 2000 and February 2003 was conducted. Patients received preoperative subcutaneous heparin (SQH) (5000u or 7500u) and every 8 hours thereafter during hospitalization. Sequential compression devices (SCD) were utilized during and after surgery unless ambulating. Early ambulation was enforced. RESULTS: 255 patients underwent LRYGBP, with 5 (1.9%) converted to open. Average preoperative weight and body mass index (BMI) were 138 kg and 50, respectively. Operative time averaged 174 minutes. Average length of stay was 2.2 days. 9 patients (3.6%) had a prior history of deep venous thrombosis/pulmonary embolism (DVT/PE), one of whom had a DVT/PE postoperatively. 2 patients developed DVT/PE within 30 days. Overall DVT/PE incidence was 1.2%. There were 6 postoperative bleeding episodes (2.4%). CONCLUSION: This regimen provides excellent prophylaxis against VTE in the hospital setting.
BACKGROUND:Venous thromboembolism (VTE) prophylaxis regimens for laparoscopic Roux-en-Y gastric bypass (LRYGBP) have not been adequately addressed in the literature. This study presents the results of our prophylactic regimen in LRYGBP at a tertiary care hospital. METHODS: A retrospective review of 255 morbidly obesepatients undergoing LRYGBP between March 2000 and February 2003 was conducted. Patients received preoperative subcutaneous heparin (SQH) (5000u or 7500u) and every 8 hours thereafter during hospitalization. Sequential compression devices (SCD) were utilized during and after surgery unless ambulating. Early ambulation was enforced. RESULTS: 255 patients underwent LRYGBP, with 5 (1.9%) converted to open. Average preoperative weight and body mass index (BMI) were 138 kg and 50, respectively. Operative time averaged 174 minutes. Average length of stay was 2.2 days. 9 patients (3.6%) had a prior history of deep venous thrombosis/pulmonary embolism (DVT/PE), one of whom had a DVT/PE postoperatively. 2 patients developed DVT/PE within 30 days. Overall DVT/PE incidence was 1.2%. There were 6 postoperative bleeding episodes (2.4%). CONCLUSION: This regimen provides excellent prophylaxis against VTE in the hospital setting.
Authors: Kimberley Eden Steele; Michael A Schweitzer; Gregory Prokopowicz; Andrew D Shore; Lisa C B Eaton; Anne O Lidor; Martin A Makary; Jeanne Clark; Thomas H Magnuson Journal: Obes Surg Date: 2011-09 Impact factor: 4.129
Authors: Khashayar Vaziri; Parag Bhanot; Eric S Hungness; Mark D Morasch; Jay B Prystowsky; Alexander P Nagle Journal: Surg Endosc Date: 2009-01-28 Impact factor: 4.584