Stroh Christine, Luderer D, Weiner R, Horbach T, Ludwig K, Benedix F, Wolff Stefanie, Knoll C, Lippert H, Manger T
Department of General, Abdominal and Pediatric Surgery, SRH Hospital, Straße des Friedens 122, 07548 Gera, Germany.
Thrombosis. 2012;2012:209052. doi: 10.1155/2012/209052. Epub 2012 Jul 9.
Background. Evidence-based data on optimal approach for prophylaxis of deep venous thrombosis (VTE) and pulmonary embolism (PE) in bariatric operations is discussed. Using antithrombotic prophylaxis weight adjusted the risk of VTE and its complications have to be balanced with the increased bleeding risk. Methods. Since 2005 the current situation for bariatric surgery has been examined by quality assurance study in Germany. As a prospective multicenter observational study, data on the type, regimen, and time course of VTE prophylaxis were documented. The incidences of clinically diagnosed VTE or PE were derived during the in-hospital course and follow up. Results. Overall, 11,835 bariatric procedures were performed between January 2005 and December 2010. Most performed procedures were 2730 gastric banding (GB); 4901 Roux-en-Y-gastric bypass (RYGBP) procedures, and 3026 sleeve gastrectomies (SG). Study collective includes 72.5% (mean BMI 48.1 kg/m(2)) female and 27.5% (mean BMI 50.5 kg/m(2)) male patients. Incidence of VTE was 0.06% and of PE 0.08%. Conclusion. VTE prophylaxis regimen depends on BMI and the type of procedure. Despite the low incidence of VTE and PE there is a lack of evidence. Therefore, prospective randomized studies are necessary to determine the optimal VTE prophylaxis for bariatric surgical patients.
背景。讨论了关于肥胖症手术中预防深静脉血栓形成（VTE）和肺栓塞（PE）的最佳方法的循证数据。使用根据体重调整的抗血栓预防措施时，VTE风险及其并发症必须与出血风险增加相平衡。方法。自2005年以来，德国通过质量保证研究对肥胖症手术的现状进行了调查。作为一项前瞻性多中心观察性研究，记录了VTE预防的类型、方案和时间过程的数据。在住院期间和随访期间得出临床诊断的VTE或PE的发生率。结果。总体而言，2005年1月至2010年12月期间共进行了11,835例肥胖症手术。最常见的手术是2730例胃束带术（GB）；4901例Roux-en-Y胃旁路术（RYGBP），以及3026例袖状胃切除术（SG）。研究群体包括72.5%（平均BMI 48.1kg/m²）的女性和27.5%（平均BMI 50.5kg/m²）的男性患者。VTE的发生率为0.06%，PE的发生率为0.08%。结论。VTE预防方案取决于BMI和手术类型。尽管VTE和PE的发生率较低，但仍缺乏证据。因此，有必要进行前瞻性随机研究以确定肥胖症手术患者的最佳VTE预防措施。
