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Incidence of Lower Limbs Deep Vein Thrombosis After Open and Laparoscopic Gastric Bypass: A Prospective Study

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Abstract

Background

Lower limbs deep vein thrombosis (DVT) and pulmonary embolism (PE) are major causes of morbidity and mortality and are even higher in bariatric patients. The longer operative time and higher immobility in these patients increase the DVT risk. Although deaths after bariatric surgery have been reported, there is no consensus regarding the prophylaxis of DVT. This study’s objective is to determine the incidence of lower limbs DVT in patients submitted to Roux-en-Y-gastric bypass (RYGBP) under prophylaxis by enoxaparin.

Methods

Patients with body mass index (BMI) equal to or higher than 35 kg/m2 who submitted to RYGBP by laparotomy or laparoscopy using 40 mg/day of enoxaparin for 15 days were recruited between October 2004 and August 2005. Individuals with previous DVT and heparin allergy were excluded. Patients were tested for DVT using color Doppler ultrasound performed before surgery and on the second and fifth weeks after surgery.

Results

The study population included 136 patients, with 126 concluding the protocol. There were 79% (100/126) of female patients aged 19 to 65 years old, with mean of 40 years SD = 10 and BMI between 35 and 61 kg/m2, mean of 43 kg/m2 (SD = 5). All patients who submitted to RYGBP were divided as 55% (69/126) by laparoscopy and 45% (57/126) by laparotomy. The incidence rate of lower limbs DVT was 0.79% (1/126).

Conclusion

The low incidence rate of DVT found in our study suggests that obesity might not be a major risk factor for venous thromboembolism in patients submitted to RYGBP.

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Acknowledgments

We thank Dr. Liliana Ronzoni, medical director of the Hospital São Rafael, for supporting our work. We thank Mrs. Ana Rosa Montenegro, librarian of the São Rafael Hospital, for assistance with articles research. We thank Mrs. Sílvia Bittencourt for assistance with data.

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Authors and Affiliations

  1. Vascular Surgery, Hospital São Rafael, Salvador, Bahia, Brazil

    Aldo L. Brasileiro, Liberato K. de Moura & Marcelo L. de Moura

  2. Escola Paulista de Medicina-UNIFESP, São Paulo, SP, Brazil

    Fausto Miranda Jr. & Luiz F. P. de Figueiredo

  3. Bariatric Surgery, Hospital São Rafael Hospital Cidade, Salvador, Bahia, Brazil

    João E. M. T. M. Ettinger, Euler Ázaro & Carlos A. B. Mello

  4. Bariatric Surgery, Hospital Cidade, Salvador, Bahia, Brazil

    João E. M. T. M. Ettinger & Euler Ázaro

  5. Escola de Ciências Médicas de Alagoas, Maceió, AL, Brazil

    Aldemar A. Castro & Guilherme B. B. Pitta

  6. General Surgery, Hospital São Rafael, Salvador, Bahia, Brazil

    Edvaldo Fahel

  7. Rua Tenente Fernando Tuy, 131, 1102, Itaigara, CEP 41 810 780, Salvador, Bahia, Brazil

    Aldo L. Brasileiro

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  1. Aldo L. Brasileiro
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  11. Luiz F. P. de Figueiredo
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Correspondence to Aldo L. Brasileiro.

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Brasileiro, A.L., Miranda, F., Ettinger, J.E.M.T.M. et al. Incidence of Lower Limbs Deep Vein Thrombosis After Open and Laparoscopic Gastric Bypass: A Prospective Study. OBES SURG 18, 52–57 (2008). https://doi.org/10.1007/s11695-007-9268-y

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  • DOI: https://doi.org/10.1007/s11695-007-9268-y

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