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Obes Surg ; 33(4): 1026-1031, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36705809

RESUMO

INTRODUCTION: Porto-mesenteric venous thrombosis (PMVT) is a significant complication that occurs more frequently after laparoscopic sleeve gastrectomy (SG) than other bariatric procedures and presents later than other venous thromboembolic (VTE) events often 2 weeks after the operation. The common current practice in bariatric surgery of perioperative chemoprophylaxis until discharge may not adequately prevent PMVT. Therefore, a 30-day post-discharge chemoprophylaxis (PDC) might reduce the incidence of PMVT. The objective of this study is to determine whether 30-day PDC with rivaroxaban 10 mg daily following SG can reduce the incidence of PMVT. METHODS: In a retrospective cohort study, 292 consecutive patients undergoing SG by a single surgeon were either prescribed rivaroxaban 10 mg daily for 30 days upon discharge (group A) or did not receive any PDC (group B). Primary outcome was PMVT and secondary outcome was bleeding. Patients on chronic anticoagulation therapy were excluded from the study. RESULTS: PMVT events differences were significant between the groups while bleeding events were not. Group A had zero PMVT events, while group B had four (p = .045). There were 4 bleeding events in group A and 7 bleeding events on group B (p = .341). CONCLUSION: A 30-day PDC regimen of rivaroxaban 10 mg daily is both safe and effective. This study demonstrated zero PMVT events without an increased risk of bleeding using this regimen.


Assuntos
Laparoscopia , Isquemia Mesentérica , Obesidade Mórbida , Trombose Venosa , Humanos , Rivaroxabana/uso terapêutico , Trombose Venosa/etiologia , Trombose Venosa/prevenção & controle , Estudos Retrospectivos , Isquemia Mesentérica/etiologia , Isquemia Mesentérica/prevenção & controle , Isquemia Mesentérica/cirurgia , Assistência ao Convalescente , Alta do Paciente , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Obesidade Mórbida/cirurgia , Veia Porta , Gastrectomia/efeitos adversos , Gastrectomia/métodos , Complicações Pós-Operatórias/etiologia , Anticoagulantes/uso terapêutico
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