J I Rodríguez1,2, V Kobus3, I Téllez3, G Pérez1. 1. Department of Surgery, Pontifical Catholic University of Chile, Santiago, Chile. 2. Department of Medical Education, Pontifical Catholic University of Chile, Santiago, Chile. 3. Medical School, Pontifical Catholic University of Chile, Santiago, Chile.
Abstract
INTRODUCTION: Portal and mesenteric venous thrombosis is a rare but potentially serious complication after laparoscopic sleeve gastrectomy. There are no consistent studies that prove the safety and effectiveness of oral anticoagulant thromboprophylaxis with rivaroxaban after laparoscopic sleeve gastrectomy. The objective was to evaluate the effect of rivaroxaban on the frequency of portal and mesenteric venous thrombosis and its safety profile after laparoscopic sleeve gastrectomy. MATERIALS AND METHODS: This retrospective analysis of prospectively collected data includes all laparoscopic sleeve gastrectomies performed by a single surgeon at Pontificia Universidad Católica de Chile Hospital between January 2009 and June 2019. All patients received low molecular weight heparin thromboprophylaxis during the whole hospital stay. Between July 2012 and June 2019, patients received additional post-discharge thromboprophylaxis with rivaroxaban. Patient demographics, impaired renal, post-surgical portal and mesenteric venous thrombosis, and bleeding episodes were registered. RESULTS: A total of 516 patients were identified; 95 patients were excluded. Results for 421 patients were analysed: 198 received only intrahospital thromboprophylaxis (group 1) and 223 received additional post-discharge thromboprophylaxis with rivaroxaban (group 2). There was no statistically significant difference between the two groups concerning age, sex and body mass index. In group 1, four cases of portal and mesenteric venous thrombosis were registered and no cases were reported in group 2 (p < 0.05). All cases occurred before 30 days after surgery. No bleeding episodes and no adverse reactions were detected in group 2. CONCLUSIONS: Thromboprophylaxis during the whole hospital stay (two to three days), followed by rivaroxaban 10mg once daily for 10 days after discharge (completing in total 13-14 days of prophylaxis), could reduce cases of post-surgical portal and mesenteric venous thrombosis without an increase in bleeding complications.
INTRODUCTION: Portal and mesenteric venous thrombosis is a rare but potentially serious complication after laparoscopic sleeve gastrectomy. There are no consistent studies that prove the safety and effectiveness of oral anticoagulant thromboprophylaxis with rivaroxaban after laparoscopic sleeve gastrectomy. The objective was to evaluate the effect of rivaroxaban on the frequency of portal and mesenteric venous thrombosis and its safety profile after laparoscopic sleeve gastrectomy. MATERIALS AND METHODS: This retrospective analysis of prospectively collected data includes all laparoscopic sleeve gastrectomies performed by a single surgeon at Pontificia Universidad Católica de Chile Hospital between January 2009 and June 2019. All patients received low molecular weight heparin thromboprophylaxis during the whole hospital stay. Between July 2012 and June 2019, patients received additional post-discharge thromboprophylaxis with rivaroxaban. Patient demographics, impaired renal, post-surgical portal and mesenteric venous thrombosis, and bleeding episodes were registered. RESULTS: A total of 516 patients were identified; 95 patients were excluded. Results for 421 patients were analysed: 198 received only intrahospital thromboprophylaxis (group 1) and 223 received additional post-discharge thromboprophylaxis with rivaroxaban (group 2). There was no statistically significant difference between the two groups concerning age, sex and body mass index. In group 1, four cases of portal and mesenteric venous thrombosis were registered and no cases were reported in group 2 (p < 0.05). All cases occurred before 30 days after surgery. No bleeding episodes and no adverse reactions were detected in group 2. CONCLUSIONS: Thromboprophylaxis during the whole hospital stay (two to three days), followed by rivaroxaban 10mg once daily for 10 days after discharge (completing in total 13-14 days of prophylaxis), could reduce cases of post-surgical portal and mesenteric venous thrombosis without an increase in bleeding complications.
Authors: Dolly A Parasrampuria; Thomas Marbury; Nobujo Matsushima; Shuquan Chen; Prachi K Wickremasingha; Ling He; Victor Dishy; Karen S Brown Journal: Thromb Haemost Date: 2015-01-08 Impact factor: 5.249
Authors: Harry R Büller; Martin H Prins; Anthonie W A Lensin; Hervé Decousus; Barry F Jacobson; Erich Minar; Jaromir Chlumsky; Peter Verhamme; Phil Wells; Giancarlo Agnelli; Alexander Cohen; Scott D Berkowitz; Henri Bounameaux; Bruce L Davidson; Frank Misselwitz; Alex S Gallus; Gary E Raskob; Sebastian Schellong; Annelise Segers Journal: N Engl J Med Date: 2012-03-26 Impact factor: 91.245
Authors: Ena Alsina; Jaime Ruiz-Tovar; Maria Remedios Alpera; Jose Gregorio Ruiz-García; Manuel Enrique Lopez-Perez; Jose Francisco Ramon-Sanchez; Francisco Ardoy Journal: J Laparoendosc Adv Surg Tech A Date: 2014-07-29 Impact factor: 1.878
Authors: Min Jun; Lisa M Lix; Madeleine Durand; Matt Dahl; J Michael Paterson; Colin R Dormuth; Pierre Ernst; Shenzhen Yao; Christel Renoux; Hala Tamim; Cynthia Wu; Salaheddin M Mahmud; Brenda R Hemmelgarn Journal: BMJ Date: 2017-10-17