IBC Oxford University Poster Abstract 5 - Adding a preoperative dose of LMWH may decrease VTE following bariatric surgery

Abstract Introduction Bariatric procedures are the most effective management for obesity. There is no standard Venous thromboembolism (VTE) prophylaxis for both dosing and duration of anticoagulation following laparoscopic sleeve gastrectomy (LSG). Aims To assess the optimum regimen for VTE prophylaxis in bariatric procedures and to reduce the incidence of perioperative bleeding. Methods This is a prospective randomized study that involved 100 morbidly obese patients, subdivided into two groups; group A received postoperative low molecular weight heparin (LMWH) prophylaxis alone starting from day one to day 15 in dose 1 mg/kg/day in a maximum dose 120 mg/day, and group B received both pre and postoperative LMWH; at night of surgery 12 hours preoperatively and postoperative starting from day one to day 15 with the same dose. All patients underwent mesenteric and bilateral lower limbs duplex 15 days postoperative using a Philips iU machine and linear (L9-3), convex (C5-1), and sector (S5-1) probes. Results The purpose of this study was to evaluate if the addition of a pre-operative regimen of low molecular weight heparin to a standard post-operative regimen decreased the incidence of VTE compared to a post-operative low molecular weight heparin regimen alone. Conclusion Preoperative as well as a postoperative prophylactic anticoagulant as LMWH is recommended to prevent perioperative VTE. There was an insignificant increase in postoperative bleeding in patients who received preoperative prophylactic anticoagulants.