VTE Prophylaxis After Gastrectomy May Boost Bleeding in Asian Patients VTE Prophylaxis After Gastrectomy May Boost Bleeding in Asian Patients

In Asian patients, symptomatic venous thromboembolism (VTE) after gastrectomy is extremely rare, and pharmacological prophylactic measures may prompt bleeding complications, Korean researchers say.Reuters Health Information
Source: Medscape Radiology Headlines - Category: Radiology Tags: General Surgery News Source Type: news

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AbstractIntroductionManagement of patients on chronic anticoagulation (AC) in bariatric surgery may present a challenge, as there is a delicate balance between risks of bleeding and thrombotic events, such as deep vein thrombosis (DVT) and pulmonary embolism (PE). The purpose of this study was to evaluate and compare rates of bleeding, thrombotic events, and outcomes of patients on preoperative AC during bariatric surgery.MethodsThe MBSAQIP data sets for 2015 and 2016 was used to identify all patients undergoing adjustable gastric banding (AGB), sleeve gastrectomy (SG), and Roux-en-Y gastric bypass (RYGB). Clinical outcome...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
The popularity of sleeve gastrectomy seems to have increased the risk of mesenteric venous thrombosis (MVT) and DVT/PE, necessitating identification of a safe, simple regimen for extended prophylaxis. Objectives: Evaluate the incidence of bleeding complications and VTE events among patients receiving apixaban for VTE prophylaxis post-op.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
This study compares 30-day outcomes between robotic-assisted and laparoscopic procedures for Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG).MethodsUsing the 2015 –2016 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database, patients between18- and 65-year-old were included. To adjust for potential confounders, 1:1 propensity-score matching (PSM) was performed using 22 preoperative characteristics. Second PSM analys is was performed adding operative time and conversion rate.Results269,923 patients underwent SG (n = 190,494) or RYGB (n =&thinsp...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
While bariatric surgical procedures have shown improvements in safety, the mitigation of venous thromboembolism (VTE) risk and iatrogenic events associated with anticoagulant chemoprophylaxis requires further investigation. Obesity is a significant risk factor for VTE development and the proposed mechanisms include increased inflammation [1], increased thrombin generation [2], and greater platelet reactivity compared to individuals without obesity [3,4]. Chemoprophylaxis has been shown to reduce VTE risk, but also increases bleeding risk, complicating surgery and increase transfusion requirements [5].
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Original articles Source Type: research
Antonio Iannelli, Patrick Treacy, Lionel Sebastianelli, Luigi Schiavo, Francesco MartiniJournal of Minimal Access Surgery 2019 15(1):1-7Sleeve gastrectomy (SG) has known a spectacular rise worldwide during the last decade. The absence of digestive anastomosis simplifies the surgical technique, reducing anastomosis-related complications such as fistula, stricture and marginal ulcer. Furthermore, the respect for digestive continuity preserves the functions of pylorus, that regulates gastric emptying, and duodenum, where calcium, B vitamins and iron are absorbed. Despite the multiple advantages, SG also has specific complicat...
Source: Journal of Minimal Access Surgery - Category: Surgery Authors: Source Type: research
ConclusionCT is an important imaging tool to diagnose post LSG complications.
Source: The Egyptian Journal of Radiology and Nuclear Medicine - Category: Nuclear Medicine Source Type: research
CONCLUSIONS: Extended thromboprophylaxis with weight-adjusted tinzaparin appears to be a safe strategy after bariatric surgery, with low rates of post-operative VTE and major bleeding. This article is protected by copyright. All rights reserved. PMID: 30099852 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - Category: Hematology Authors: Tags: J Thromb Haemost Source Type: research
In this issue ofJAMA Surgery, Jung and colleagues examine the safety and efficacy of venous thromboembolism (VTE) prophylaxis in Korean patients undergoing gastrectomy for cancer. Their randomized clinical trial found decreased postoperative VTE with the use of low-molecular-weight heparin in addition to mechanical prophylaxis, compared with the use of mechanical prophylaxis alone. However, the authors claim that, because the VTE rate was low and the rate of bleeding was increased, VTE prophylaxis (low-molecular-weight heparin plus intermittent pneumatic compression) still may not be the right choice for all patients under...
Source: JAMA Surgery - Category: Sports Medicine Source Type: research
AbstractPurposeLaparoscopic sleeve gastrectomy (LSG) has rapidly gained popularity as a single-stage operation for the treatment of morbid obesity, as patients undergoing LSG have been shown to achieve similar weight loss and resolution of obesity-related comorbidities in comparison to those undergoing Roux-en-Y gastric bypass (RYGB), the “gold standard” bariatric operation. Although LSG poses fewer technical challenges than RYGB, little is known about differences in short-term outcomes among patients undergoing LSG and RYGB. We hypothesized that LSG is associated with lower 30-day risk-adjusted serious morbidi...
Source: Obesity Surgery - Category: Surgery Source Type: research
AbstractBackgroundStudies examining utilization and impact of venous thromboembolism (VTE) chemoprophylaxis for patients undergoing bariatric surgery are limited. Determination of the optimal prophylactic regimen to minimize complications is crucial.MethodsThe Cerner Health Facts database from 2003 to 2013 was queried using ICD-9 codes to identify patients undergoing laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB). VTE chemoprophylaxis regimens were divided into pre-operative alone (PreP), post-operative alone (PostP), both pre-operative and post-operative (PPP), or no prophylaxis (NP). Specific c...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
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