An Approach to Venous Thromboembolism Prophylaxis in Laparoscopic Roux-en-Y Gastric Bypass Surgery.
BACKGROUND: Venous thromboembolism (VTE) prophylaxis regimens for laparoscopic Roux-en-Y gastric bypass (LRYGBP) have not been adequately addressed in the literature. This study presents the results of our prophylactic regimen in LRYGBP at a tertiary care hospital.
METHODS: A retrospective review of 255 morbidly obese patients undergoing LRYGBP between March 2000 and February 2003 was conducted. Patients received preoperative subcutaneous heparin (SQH) (5000u or 7500u) and every 8 hours thereafter during hospitalization. Sequential compression devices (SCD) were utilized during and after surgery unless ambulating. Early ambulation was enforced.
RESULTS: 255 patients underwent LRYGBP, with 5 (1.9%) converted to open. Average preoperative weight and body mass index (BMI) were 138 kg and 50, respectively. Operative time averaged 174 minutes. Average length of stay was 2.2 days. 9 patients (3.6%) had a prior history of deep venous thrombosis/pulmonary embolism (DVT/PE), one of whom had a DVT/PE postoperatively. 2 patients developed DVT/PE within 30 days. Overall DVT/PE incidence was 1.2%. There were 6 postoperative bleeding episodes (2.4%).
CONCLUSION: This regimen provides excellent prophylaxis against VTE in the hospital setting.
Published In/Presented At
Miller, M. T., & Rovito, P. F. (2004). An approach to venous thromboembolism prophylaxis in laparoscopic Roux-en-Y gastric bypass surgery. Obesity Surgery, 14(6), 731-737.
Medicine and Health Sciences | Other Medical Specialties | Surgery
Department of Surgery, Department of Medicine