Incidence of venous thromboembolism in laparoscopic bariatric surgery : preliminary report

Background: Laparoscopic bariatric surgery, due to short operative duration and early ambulation of the patients, has reduced the incidence of postoperative venous thromboembolism (VTE) in morbidly obese patients.We evaluated the incidence of VTE in laparoscopic gastric banding for morbid obesity, and determined the optimal duration of heparin prophylaxis comparing two different regimens of low molecular weight heparin (LMWH). Methods: Since December 2002, two groups of patients, both males and females, underwent laparoscopic gastric banding for morbid obesity. Both groups were treated with LMWH 4,000 U/day, for different periods of time. Group A (49 patients, mean age: 38 years, mean BMI: 41.8) was treated until hospital discharge (3-4 days). Group B (38 patients, mean age: 37 years,, mean BMI 42.3) was treated for 10 days postoperatively. All patients wore elastic compression stockings and were early ambulant. The incidence of VTE was assessed by means of a standardized Color Doppler, performed before the operation, at the 3rd and 10th postoperative day, and a clinical check after 1 and 3 months. Results: Neither deep vein thrombosis nor pulmonary embolism were observed in either groups. In Group A, after suspension of LMWH, superficial thrombophlebitis occurred in 2 patients, who had saphenous reflux, which required readministration of LMWH. Conclusion: This preliminary report shows that the incidence of venous thromboembolism is low in laparoscopic gastric banding. The occurence of 2 superficial thromboses suggests, however, the need for a longer heparin prophylaxis