Fondaparinux to Prevent Venous Thromboembolism after Bariatric Surgery: An Observational Clinical Trial

Gaspard Bouteloup, Abdessalem Ghedira, Mohamed Ali Chaouch, Adrien Faul, Carlotta Ferretti, Sofia Usai, Zeina Farah, Clara Cesari, Marc Beaussier, Marie-Christine Boutron- Ruault and Guillaume Pourcher

Department of Digestive, Oncologic and Metabolic Surgery, Obesity Center, Institute Mutualiste Montsouris, Paris, France Department of Anesthesiology, Institute Mutualiste Montsouris, Paris, France Centre de Recherche en Epidémiologie et Santé des Populations (CESP), INSERM, Paris-Saclay University, France

^*Correspondance to: Guillaume Pourcher 

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Abstract:

Background: Bariatric surgery is associated with a higher risk of thromboembolism complications and requires longer thromboprophylaxis. After hospital discharge, we could use Fondaparinux. This study aimed to assess the effectiveness of Fondaparinux use for postoperative thromboprophylaxis after bariatric surgery. Methods: This prospectively collected data study of consecutive patients undergoing bariatric surgery given Enoxaparin for prophylaxis (40 mg single dose immediately after surgery) followed by Fondaparinux after hospital discharge (2.5 mg to 5 mg for 10 days to 15 days). The outcomes measures were evaluated by questioning, computed tomography, postoperative thromboembolic, and bleeding. The follow-up was of 12 months. Results: One hundred fifty-four patients were enrolled. Eighty-five patients were discharged on the day of surgery and 86 patients on the following day. Before discharge (during Enoxaparin thromboprophylaxis), one patient was identified with asymptomatic pulmonary embolism, one with a major bleeding event, and seven with minor bleeds. One hundred thirty-eight patients (89.6%) were evaluable at 12 months. After discharge, there is no thromboembolic or bleeding events. None of the patients died during the follow-up. Conclusion: Fondaparinux appears safe when used for postoperative thromboprophylaxis following bariatric surgery.

Keywords:

Fondaparinux; Enoxaparin; Venous thromboembolism; Thromboprophylaxis; Bariatric surgery; Laparoscopy; Bleeding

Cite the Article:

Bouteloup G, Ghedira A, Ali Chaouch M, Faul A, Ferretti C, Usai S, et al. Fondaparinux to Prevent Venous Thromboembolism after Bariatric Surgery: An Observational Clinical Trial. World J Surg Surgical Res. 2022;5:1377..