title: Prevention of venous thromboembolism in patients undergoing bariatric surgery.
abstract: Bariatric surgical procedures are now a common method of obesity treatment with established effectiveness. Venous thromboembolism (VTE) events, which include deep vein thrombosis and pulmonary embolism, are an important source of postoperative morbidity and mortality among bariatric surgery patients. Due to an understanding of the frequency and seriousness of these complications, bariatric surgery patients typically receive some method of VTE prophylaxis with lower extremity compression, pharmacologic prophylaxis, or both. However, the optimal approach in these patients is unclear, with multiple open questions. In particular, strategies of adjusted-dose heparins, postdischarge anticoagulant prophylaxis, and the role of vena cava filters have been evaluated, but only to a limited extent. In contrast to other types of operations, the literature regarding VTE prophylaxis in bariatric surgery is notable for a dearth of prospective, randomized clinical trials, and current professional guidelines reflect the uncertainties in this literature. Herein, we summarize the available evidence after systematic review of the literature regarding approaches to VTE prevention in bariatric surgery. Identification of risk factors for VTE in the bariatric surgery population, analysis of the effectiveness of methods used for prophylaxis, and an overview of published guidelines are presented.
authors: Division of General Internal Medicine, Mayo Clinic Thrombophilia Center, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
authors: Matthew A
authors: MA
authors: Bartlett
authors: Division of General Internal Medicine, Mayo Clinic Thrombophilia Center, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
authors: Karen F
authors: KF
authors: Mauck
authors: Division of General Internal Medicine, Mayo Clinic Thrombophilia Center, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
authors: Paul R
authors: PR
authors: Daniels
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D050110:Bariatric Surgery / Q000009:adverse effects*; D006801:Humans; D009765:Obesity / Q000097:blood / Q000150:complications / Q000601:surgery*; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D013923:Thromboembolism / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D016306:Vena Cava Filters / Q000009:adverse effects; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants
keywords: bariatric surgery; heparin; prophylaxis; vena cava filter; venous thromboembolism