Background: Laparoscopic bariatric surgery, due to short operative
duration and early ambulation of the patients, has reduced
the incidence of postoperative venous thromboembolism (VTE)
in morbidly obese patients.We evaluated the incidence of VTE in
laparoscopic gastric banding for morbid obesity, and determined
the optimal duration of heparin prophylaxis comparing two different
regimens of low molecular weight heparin (LMWH).
Methods: Since December 2002, two groups of patients, both
males and females, underwent laparoscopic gastric banding for
morbid obesity. Both groups were treated with LMWH 4,000
U/day, for different periods of time. Group A (49 patients, mean
age: 38 years, mean BMI: 41.8) was treated until hospital discharge
(3-4 days). Group B (38 patients, mean age: 37 years,,
mean BMI 42.3) was treated for 10 days postoperatively. All
patients wore elastic compression stockings and were early
ambulant. The incidence of VTE was assessed by means of a
standardized Color Doppler, performed before the operation, at
the 3rd and 10th postoperative day, and a clinical check after 1
and 3 months.
Results: Neither deep vein thrombosis nor pulmonary
embolism were observed in either groups. In Group A, after suspension
of LMWH, superficial thrombophlebitis occurred in 2
patients, who had saphenous reflux, which required readministration
of LMWH.
Conclusion: This preliminary report shows that the incidence of
venous thromboembolism is low in laparoscopic gastric banding.
The occurence of 2 superficial thromboses suggests, however,
the need for a longer heparin prophylaxi
