Assessing the Efficacy of Extended Postoperative Enoxaparin as Thromboprophylaxis for Patients Undergoing Laparoscopic Sleeve Gastrectomy: a Prospective Analysis.

BACKGROUND

Venous thromboembolism (VTE), encompassing deep venous thrombosis (DVT) and pulmonary embolism (PE), presents significant morbidity and mortality risks post-bariatric surgery. Despite the recognized need for thromboprophylaxis, optimal strategies, particularly regarding the duration and dosing of chemoprophylaxis, remain under debate.

OBJECTIVE

This study evaluates the efficacy of standard versus extended chemoprophylaxis with enoxaparin in preventing VTE following laparoscopic sleeve gastrectomy (LSG) at King Abdullah University Hospital in Irbid, Jordan.

METHODS

A prospective cohort study included patients undergoing LSG from January to July 2023. Excluding high-risk individuals based on specific criteria, participants were randomized into two groups: standard prophylaxis (Group A) and extended prophylaxis with enoxaparin for 14 days post-discharge (Group B). Both groups were assessed preoperatively and followed up to one month postoperatively for signs of DVT via venous Doppler ultrasound and for any complications related to enoxaparin use.

RESULTS

Of the 116 patients studied, no DVT incidents were reported across both groups. Preoperative and postoperative assessments showed significant weight loss, with no complications associated with enoxaparin. Statistical analysis indicated no significant difference in DVT prevention between groups. The study's findings align with existing literature, underscoring the safety of enoxaparin but questioning its impact on DVT incidence post-LSG.

CONCLUSION

The study concludes that extended chemoprophylaxis with enoxaparin post-LSG is safe, with no reported adverse effects. However, its efficacy in significantly reducing postoperative DVT incidence remains uncertain. These outcomes suggest the need for further research with larger sample sizes to optimize thromboprophylaxis strategies, considering patient-specific factors and potential risks.