Risk of thrombosis and thromboembolic prophylaxis in obesity surgery: data analysis from the German Bariatric Surgery Registry

“…When comparing different chemoprophylaxis agents, The Michigan bariatric surgery collaborative reported that (LMWH) is more effective the UF in patients undergoing Bariatric surgery without increasing bleeding rate [15]. In addition, LMWH was also reported as the most commonly used agent in both the French national survey and the German Bariatric Surgery Registry data study [3,14]. Furthermore, Nimeri, et al successfully reduced VTE rates after bariatric surgery from 2.2% in 2011 to 0.35% in 2016 after switching from heparin to LMWH, initiating mandatory risk assessment using Caprini scoring for VTE and adopting an aggressive strategy for high-risk patients regarding dosage of LMWH and chemoprophylaxis after discharge [16].…”

Section: Resultsmentioning

confidence: 99%

“…With the rising number of bariatric surgeries, we expect a rise in complications including venous thromboembolism (VTE). The incidence of VTE as reported in the literature ranges from 0.07 to 1.9% at 30 days and rises to 2.1% at 180 days [2][3][4][5][6]. The aim of this survey is to study the incidence of VTE and the practice of VTE thromboprophylaxis in the Middle East region represented by members of the Pan Arab Society of Metabolic and Bariatric Surgery (PASMBS).…”

Section: Introductionmentioning

confidence: 99%

Venous Thromboembolism and Bariatric Surgery in the Middle East Region

Ashraf¹,

Ahmad²,

Al³

et al. 2019

J Obes Weight-Loss Medic

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Introduction: Venous thromboembolism (VTE) is a major cause of morbidity and mortality after bariatric surgery. Methods: We designed a survey to study VTE after bariatric surgery in the Middle East & North Africa region (MENA). We used Survey Monkey and uploaded the survey in our PASMBS social media platforms. Results: Eighty-two surgeons (63%) responded, they performed 121,369 cases and encountered 230 VTEs (0.19%). VTEs included 13 upper extremity, 103 lower extremity, 57 pulmonary embolism (PE), and 57 portomesenteric venous thrombosis (PMT). There was 9 VTE related mortalities constituting 4% mortality rate. The most commonly performed procedure was Sleeve Gastrostomy (56%). It was followed by Adjustable Gastric band (13%), One Anastomosis Gastric Bypass (10%), and Roux-en-Y Gastric bypass (9%). A scoring tool for VTE was used by 62% of surgeons and Caprini was the most commonly used tool and 62% of surgeons reported having at least one incident of VTE. Sequential compression devices were used by 57% of surgeons. Low molecular weight heparin was the most commonly used chemoprophylaxis. LMWH 40 mg once a day was used in 53% of the moderate risk group, 26% of the high-risk group and 6% in the highest risk group. Post-discharge, chemoprophylaxis was continued in the moderate, high and highest risk patients 82%, 95%, and 98% respectively. Conclusion: VTE risk assessment and the use of chemoprophylaxis for VTE is common in the MENA region. However, many patients continue to receive sub-therapeutic doses of low molecular heparin during the hospital stay and after discharge.

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“…Specifically, the impact of alternative medications is not as well as Heparin. On the other hand, in patients with bypass surgery who have oral medication intolerance or malabsorption, intravenous Heparin administration is much more effective than oral alternative medications (17).…”

Section: Rule Out Other Causes Such As Sepsis Etcmentioning

confidence: 99%

Idiopathic Thrombocytopenia After Omega Gastric Bypass Surgery: A Case Report

Sayadishahraki

Dehghan

Mahmoudieh

et al. 2017

J Minim Invasive Surg Sci

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Introduction: After cessation of smoking, the best way to prevent health-threatening conditions is to treatment of obesity. Also, obesity treatment, cause alleviation or cure of other diseases. Bariatric surgery in selected obese patients is the best option for preventing health-threatening conditions. Despite the health benefits, this method of treatment -just like other surgical proceduresmay be associated with various side effects. Case Presentation: A 55-year-old female with BMI of 46.5 underwent laparoscopic Omega Gastric bypass surgery. She was admitted due to dyspnea and pulmonary embolism 14 days later. In conducted surveys, platelet count was less than 25,000. In multiple assessments, no cause found for the thrombocytopenia. Corticosteroids prescribed for her with the diagnosis of ITP; which fully responded to treatment. Conclusions: Thrombocytopenia is a rare complication of gastric bypass surgery. Managements include rule out of other causes of thrombocytopenia and medical treatment.

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Risk of thrombosis and thromboembolic prophylaxis in obesity surgery: data analysis from the German Bariatric Surgery Registry

Cited by 29 publications

References 33 publications

Thromboelastography Values Remain Hypercoagulative 6 Months After Obesity Surgery: a Pilot Study

Thromboelastography Values Remain Hypercoagulative 6 Months After Obesity Surgery: a Pilot Study

Venous Thromboembolism and Bariatric Surgery in the Middle East Region

Idiopathic Thrombocytopenia After Omega Gastric Bypass Surgery: A Case Report

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