title: Therapeutic effect of low-molecular weight heparin and incidence of lower limb deep venous thrombosis and pulmonary embolism after laparoscopic bariatric surgery.
abstract: BACKGROUND
  The aim of our study was to determine the therapeutic effect of low-molecular weight heparin after laparoscopic Roux-en-Y gastric bypass.
  
  
  METHODS
  We prospectively analyzed data of 39 patients who underwent Roux-en-Y gastric bypass from 1093 consecutive patients who underwent bariatric procedures from May 1999 to May 2012. All patients were given 40 mg enoxaparin subcutaneously once daily preoperatively and continued for 5 days.
  
  
  RESULTS
  There were 31 females. Mean age was 32.48 years and mean body mass index was 44.59 kg/m. Only 46.1% of patients reached the defined therapeutic dose on the second day and 41% on the fifth day. One fatal pulmonary embolism was recorded (1/1093, 0.09%) in the entire series.
  
  
  CONCLUSIONS
  Anti-Xa surveillance did not correlate strongly with outcome. Further studies are required for proper dose adjustments of low-molecular weight heparin in these obese patients and whether anti-Xa monitoring should be continued.
authors.affiliation: Departments of *Surgery §Pathology, Kuwait University Faculty of Medicine, Safat Departments of †Surgery ‡Vascular Lab, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait ∥First Department of Surgery, Hippocration Hospital, University of Athens Medical School, Athens, Greece.
authors.forename: Mousa
authors.initials: M
authors.lastname: Khoursheed
authors.forename: Ibtisam
authors.initials: I
authors.lastname: Al-Bader
authors.forename: Fahad
authors.initials: F
authors.lastname: Al-Asfar
authors.forename: Ali
authors.initials: A
authors.lastname: Sayed
authors.forename: Abdulaziz
authors.initials: A
authors.lastname: Al-Mozaini
authors.forename: Rajaa
authors.initials: R
authors.lastname: Marouf
authors.forename: Abe
authors.initials: A
authors.lastname: Fingerhut
mesh_terms: D000293:Adolescent; D000328:Adult; D000713:Anastomosis, Roux-en-Y; D050110:Bariatric Surgery; D017984:Enoxaparin / Q000008:administration & dosage; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D010535:Laparoscopy; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000209:etiology*; D018608:Ultrasonography, Doppler; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*
chemical_list: D017984:Enoxaparin; D006495:Heparin, Low-Molecular-Weight