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Year : 2017  |  Volume : 36  |  Issue : 4  |  Page : 368-371

Value of pharmacologic thromboprophylaxis for prevention of thromboembolic complications in bariatric surgery

1 Department of General Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
2 Deapartment of Radiodiagnosis, Faculty of Medicine, Cairo University, Cairo, Egypt

Correspondence Address:
Hany A Balamoun
Department of General Surgery, Faculty of Medicine, Cairo University, Cairo - 11562
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ejs.ejs_50_17

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Objective The objective of this study was to assess safety and efficacy of pharmacologic thromboprophylaxis in morbidly obese patients undergoing bariatric surgery for prevention of silent deep vein thrombosis (DVT). Patients and methods This prospective study included 50 morbidly obese patients scheduled for primary one-stage laparoscopic bariatric surgery randomly allocated into one of two treatment groups according to the method of thromboprophylaxis. Group M (n=25) was subjected to mechanical prophylaxis with bilateral graduated compression stockings. Group MC (n=25) was subjected to mechanical plus pharmacologic prophylaxis using 40 mg of the low-molecular-weight heparin enoxaparin subcutaneously, 12 h before surgery, and postoperatively daily for 2 weeks. Bilateral lower limb venous duplex was done to detect silent DVT (the primary outcome measure), before discharge and after 2 weeks. Results Three patients developed silent DVT (6%); all of them were among group M (P=0.235, relative risk: 0.47, 95% confidence interval: 0.35–0.64). There was no significant difference between patients with DVT and those without DVT regarding age, BMI, operative time, comorbidities, or type of surgery. No bleeding complications were recorded in the two studied groups. Conclusion Perioperative low-molecular-weight heparin extending for 2 weeks postoperatively combined with graduated compression stockings is safe and effective for the prevention of silent DVT following laparoscopic bariatric surgery.

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