AI Article Synopsis
- The study evaluated the impact of different VTE prophylaxis strategies on bleeding and VTE occurrence in patients undergoing bariatric surgery at four hospitals.
- A total of 2145 surgeries were analyzed, revealing a higher rate of postoperative bleeding in patients who received preoperative VTE prophylaxis compared to those who did not.
- Despite the increased bleeding risk, the rates of VTE were not significantly different between patients who received prophylaxis and those who did not.
Article Abstract
Background: Use of chemoprophylaxis for prevention of venous thromboembolism (VTE) after bariatric surgery is a generally accepted principle; however, the optimal strategy in terms of medication type and pre- and postoperative dosing is uncertain. In our healthcare system, four hospitals performed bariatric surgery and utilized differing protocols for VTE prophylaxis. The analysis sought to evaluate the association of differing prophylaxis strategies on bleeding and VTE occurrence.
Methods: Adult patients who underwent laparoscopic sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) from 2018 to 2021 at four hospitals were studied. Patients were grouped by whether or not they received preoperative chemoprophylaxis. The primary outcome was postoperative bleeding, defined as requiring a blood transfusion or reoperation for bleeding within 30 days. Bivariate analyses were performed with Chi-square and Wilcoxon Rank tests where applicable. Multivariate logistic regression was performed for the outcome of postoperative bleeding.
Results: A total of 2145 bariatric surgeries were evaluated (33.6% RYGB, 66.4% SG). Among 1712 patients who underwent surgery at Hospitals A, B, and C, 93.1% received preoperative VTE prophylaxis, compared with 1 patient (0.1%) among 433 patients operated on at Hospital D. Postoperative bleeding occurred more frequently in patients who received preoperative VTE prophylaxis versus those who did not (3.7% vs 1.1%; p < 0.01). After multivariable regression analysis, only RYGB (OR 3.59; p < 0.01) and preoperative VTE prophylaxis (OR 3.54; p = 0.02) were significantly associated with postoperative bleeding. Rates of VTE for patients receiving preoperative VTE prophylaxis or no prophylaxis were not significantly different (0.6% vs. 0.2%; p = 0.26).
Discussion: Preoperative VTE prophylaxis prior to bariatric surgery was associated with postoperative bleeding without differences in VTE occurrence. These results call into question the routine use of VTE chemoprophylaxis for all patients undergoing bariatric surgery and favor selective usage.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00464-024-11288-7 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Obesity is a metabolic disease that is marked by excessive fat accumulation and is objectively defined as a body mass index (BMI) ≥30 kg/m2. Obesity is associated with several other comorbidities, including psoriasis, which is a chronic autoimmune skin disease. Adipocytes produce pro-inflammatory signaling molecules, namely adipokines and classic cytokines, that drive increased inflammation axnd may contribute to the pro-inflammatory pathways driving psoriasis disease pathogenesis.
View Article and Find Full Text PDFCritical Time Points for Assessing Long-Term Clinical Response After Sleeve Gastrectomy-A Retrospective Study of Patients with 13-Year Follow-Up.
Obes Surg
January 2025
Division of Bariatric and Metabolic Surgery, University General Hospital of Patras, Patras, Greece.
Background: Weight loss after sleeve gastrectomy (SG) demonstrates significant diversity in the long term and the implicated mechanisms behind suboptimal clinical response (SCR) or recurrent weight gain (RWG) need to be scrutinized. This study retrospectively examines weight-loss trajectories, aiming to identify critical time points to optimize follow-up strategies and guide future prospective research.
Methods: This is a single-center, retrospective study of 104 patients that underwent SG.
Surgeons transitioning from laparoscopic to robotic-assisted inguinal hernia repair: a prospective analysis of efficiency.
Hernia
January 2025
Department of Surgery, Baptist Health South Florida, Miami, FL, USA.
Background: Available reports of surgeon efficiency when transitioning from laparoscopic to robotic-assisted (RA) inguinal hernia repair (IHR) are retrospective or describe single-center experience. The purpose of this study is to provide a prospective, multi-surgeon, multi-center assessment of surgeon efficiency when transitioning from Lap-IHR to RA-IHR.
Methods: General surgeons with Lap-IHR experience (≥300 Lap-IHRs prior to the study) but with no robotic experience (no RA cases one year prior to the study) consented to participate in this prospective, observational pilot study of their surgical efficiency as they adopted RA-IHR.
Care Fragmentation Following Bariatric Operations: A National Analysis.
Am Surg
January 2025
Department of Surgery, University of California, Los Angeles, CA, USA.
Background: Although existing work has evaluated outcomes associated with care fragmentation (CF), these adverse consequences may be accentuated in patients undergoing bariatric operations. This retrospective study examined the association of CF with clinical and financial outcomes among patients receiving bariatric surgery.
Methods: All adult (≥18 years) records for bariatric operations were tabulated from the 2016-2021 Nationwide Readmissions Database.
A Case of Pediatric Internal Hernia Heralded by Constipation.
Cureus
December 2024
Emergency Medicine, Madigan Army Medical Center, Tacoma, USA.
Meckel's diverticulum (MD) is the most common gastrointestinal congenital anomaly of the small intestine. A small subset of patients with MD develops a mesodiverticular band (MDB), creating a snare-like opening and the potential for internal hernias (IHs). IHs are a known possible cause of small bowel obstructions and are most common in adults post bariatric surgery.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!