Hacı Hasan Abuoglu1, M A Tolga Müftüoğlu2, Mehmet Odabaşı2. 1. Haydarpaşa Numune Training and Research Hospital General Surgery Clinic, Tıbbiye Cad. No. 23, 34668, Üsküdar/İstanbul, Turkey. abuoglu@gmail.com. 2. BAU Medical Park Göztepe Hospital, 23 Nisan Sok. No: 17, Merdivenköy, 34732, Kadıköy/İstanbul, Turkey.
Abstract
BACKGROUND: 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. RESULTS: 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. CONCLUSION: Low dosage LMWH with PCD is very effective for VTE prophylaxis in bariatric surgery.
BACKGROUND: Morbidly obesepatients 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. RESULTS: 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. CONCLUSION: Low dosage LMWH with PCD is very effective for VTE prophylaxis in bariatric surgery.
Authors: William H Geerts; David Bergqvist; Graham F Pineo; John A Heit; Charles M Samama; Michael R Lassen; Clifford W Colwell Journal: Chest Date: 2008-06 Impact factor: 9.410
Authors: Ronald H Clements; Kishore Yellumahanthi; Naveen Ballem; Mary Wesley; Kirby I Bland Journal: J Am Coll Surg Date: 2009-05 Impact factor: 6.113
Authors: Stavros K Kakkos; Joseph A Caprini; George Geroulakos; Andrew N Nicolaides; Gerard Stansby; Daniel J Reddy; Ioannis Ntouvas Journal: Cochrane Database Syst Rev Date: 2016-09-07