Enoxaparin vs Fondaparinux for VTE Prophylaxis in Laparoscopic sleeve gastrectomy

Background In Laparoscopic bariatric surgeries, the chance of venous thromboembolism (VTE) rises, which can have severe consequences(1). This comparative study seeks to analyze the efficacy and safety of enoxaparin and fondaparinux, two popular anticoagulants employed to prevent VTE following bariatric surgeries.ObjectiveThe objective of this study is to compare the efficacy and safety of enoxaparin and fondaparinux for VTE prophylaxis in laparoscopic sleeve surgeries, with a focus on their impact on bleeding risk.Methods This prospective randomized trial included 100 patients undergoing laparoscopic sleeve gastrectomy and compared the effectiveness and safety of fondaparinux and enoxaparin in the prevention of venous thromboembolism (VTE). These patients were divided into two groups at random: group A received postoperative enoxaparin at a dosage of 40 mg administered subcutaneously once a day; Group B received fondaparinux at a dosage of 2.5 mg administered subcutaneously once daily. The anticoagulant regimen was continued for 10 days post-surgery for both groups, with administration beginning three hours after surgery. The study aimed to assess the incidence of VTE events and bleeding complications, with patients being followed up for 4 weeks postoperatively.Results The study found that there were no statistically significant differences in age, body mass index, comorbidity prevalence rates, venous thromboembolism detection workup, operative time, blood loss, minor drain bleeding, leakage, ICU admission, or GERD. However, Group B had higher VTE risk assessment scores, indicating an increased risk of VTE compared to Group A. ConclusionEnoxaparin and fondaparinux are viable VTE prophylaxis options following LSG surgery. Selection should consider patients' risk factors, comorbidities, and any contraindications or side effects. The study found no significant statistical differences between the two drugs' efficacy in preventing VTE for LSG surgery patients.