Thromboprophylaxis after bariatric surgery

Almarshad, Feras; Almegren, Mosaad; Alshuaibi, Turki; Alobaodi, Nadiah; Almutawa, Ali; Basunbl, Hajer; Algahtani, Farjah H.; Rawahi, Bader Al

doi:10.5045/br.2020.55.1.44

Cited by 27 publications

(12 citation statements)

References 26 publications

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“…16,17 Furthermore, there is mounting evidence supporting its use after bariatric, liver and pancreas surgeries. 18,19 Therefore, it is imperative that consensus guidelines are continually revised to reflect the latest research developments.…”

Section: Discussionmentioning

confidence: 99%

“…This is despite recent meta‐analyses demonstrating its safety and efficacy after abdominopelvic surgery for malignant and benign diseases 16,17 . Furthermore, there is mounting evidence supporting its use after bariatric, liver and pancreas surgeries 18,19 . Therefore, it is imperative that consensus guidelines are continually revised to reflect the latest research developments.…”

Section: Discussionmentioning

confidence: 99%

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Variations in practice of thromboprophylaxis across general surgical subspecialties: a multicentre (PROTECTinG) study of elective major surgeries

Liu

Stevens

Wong

et al. 2020

ANZ Journal of Surgery

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Background: Despite guidelines recommending perioperative thromboprophylaxis for patients undergoing general surgery, we have observed significant variations in its practice. This may compromise patient safety. Here, we quantify the heterogeneity of perioperative thromboprophylaxis across all major general surgical operations, and place them in relation to their risk of bleeding and venous thromboembolism. Methods: Retrospective review of all elective major general surgeries performed between 1 January 2018 and 30 June 2019 across seven Victorian hospitals was conducted. Results: A total of 5912 patients who underwent 6628 procedures were reviewed. Significant heterogeneity was found in the use of chemoprophylaxis, timing of its initiation, type of anticoagulant administered and application of extended chemoprophylaxis. These variations were observed within the same procedure, and between different surgeries and subspecialties. Contrastingly, there was minimal heterogeneity with the use of mechanical thromboprophylaxis. Oesophago-gastric, liver and colorectal cancer resections had the highest thromboembolic risk. Breast, oesophago-gastric, liver, pancreas and colon cancer resections had the highest bleeding risk. Conclusion: Perioperative chemoprophylaxis across general surgery is highly variable. This study has highlighted key areas of variance. Our findings also enable surgeons to compare their practices, and provide baseline data to inform future efforts towards optimizing thromboprophylaxis for general surgical patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Variations in practice of thromboprophylaxis across general surgical subspecialties: a multicentre (PROTECTinG) study of elective major surgeries

Liu

Stevens

Wong

et al. 2020

ANZ Journal of Surgery

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“…The importance of correct dosing based on patients’ weight and renal function is especially important in the bariatric cardiac surgery population. In a prospective study involving 374 bariatric surgery patients carried out by Almarshad et al, 83 an extended 14‐day course of VTE prophylaxis consisting of enoxaparin 40 mg twice daily was shown at 3 months follow‐up to result in no incidences of bleeding or VTE‐associated mortality. The use of extended thromboprophylaxis postcardiac surgery is likely to depend on the invasiveness of the procedure undertaken, coexistent anticoagulant use, and individual bleeding risk.…”

Section: Methodsmentioning

confidence: 98%

Cardiac surgery in the morbidly obese

Djouani

Smith

Choi

et al. 2022

Journal of Cardiac Surgery

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Background: Obesity rates globally continue to rise and in turn the body mass index (BMI) of patients undergoing cardiac surgery is set to mirror this. Patients who are Class III obese (BMI ≥ 40) pose significant challenges to the surgical teams responsible for their care and are also at high risk of complications from surgery and even death. To improve outcomes in this population, interventions carried out in the preoperative, operative, and postoperative periods have shown promise. Despite this, there are no defined best practice national guidelines for perioperative management of obese patients undergoing cardiac surgery.Aim: This review is aimed at clinicians and researchers in the field of cardiac surgery and aims to form a basis for the future development of clinical guidelines for the management of obese cardiac surgery patients. Methods:The PubMed database was utilized to identify relevant literature and strategies employed at various stages of the surgical journey were analyzed.Conclusions: Data presented identified the benefits of preoperative respiratory muscle training, off-pump coronary artery bypass grafting where possible, and early extubation. Further randomized controlled trials are required to identify optimal operative and perioperative management strategies before the introduction of such guidance into clinical practice.

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“…Se recomienda seguir todas las medidas de tromboprofilaxis postoperatoria. 49 Se sugiere colocar drenajes para vigilar y prevenir la formación de seromas. 50 Algunos autores recomiendan aplicar bloqueos nerviosos intercostales y pararrectales para reducir el tiempo de recuperación y la necesidad de analgésicos.…”

Section: Cuidados Postoperatoriosunclassified