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Background <p>Like any major operation, sleeve gastrectomy (SG) has its reported postoperative complications. Among them are venous thromboembolic complications (VTE) that may predispose to mortality. Despite the proven efficacy of the traditional anticoagulants, such as low molecular weight heparins (LMWHs) for VTE management, they have their limitations. Direct oral anticoagulants (DOACs) have been currently adopted for the management of VTE. We conducted this study to evaluate the efficacy and safety of apixaban against VTE after laparoscopic sleeve gastrectomy in comparison with LMWH.</p> Methods <p>This was a randomized controlled trial that included 100 adult patients who underwent SG and received LMWH (Group A) or apixaban (Group B) for VTE prophylaxis. We recorded and analyzed the postoperative events up to the 30th day after surgery.</p> Results <p>This study included Group A (n = 50) and Group B (n = 50). No VTE occurred in either group (0%). Postoperative bleeding was encountered in one patient of each group (2%). The follow-up venous Doppler study was unremarkable in the two groups.</p> Conclusion <p>Apixaban was shown to be comparable to LMWH for the prevention of VTE after LSG with similar efficacy and safety making it a promising alternative to LMWH in patients undergoing bariatric surgery.</p>

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Comparison between low molecular weight heparin and apixaban (direct oral anticoagulant) in the prophylaxis against venous thromboembolism after laparoscopic sleeve gastrectomy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月8日

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  • Ahmed Abdelsalam,
  • Michael Fikry,
  • Ahmed Fahmy,
  • Tarek Hegazy,
  • Afaf Hamdy,
  • Ahmed Refaat,
  • Ahmed Elansary

摘要

Background

Like any major operation, sleeve gastrectomy (SG) has its reported postoperative complications. Among them are venous thromboembolic complications (VTE) that may predispose to mortality. Despite the proven efficacy of the traditional anticoagulants, such as low molecular weight heparins (LMWHs) for VTE management, they have their limitations. Direct oral anticoagulants (DOACs) have been currently adopted for the management of VTE. We conducted this study to evaluate the efficacy and safety of apixaban against VTE after laparoscopic sleeve gastrectomy in comparison with LMWH.

Methods

This was a randomized controlled trial that included 100 adult patients who underwent SG and received LMWH (Group A) or apixaban (Group B) for VTE prophylaxis. We recorded and analyzed the postoperative events up to the 30th day after surgery.

Results

This study included Group A (n = 50) and Group B (n = 50). No VTE occurred in either group (0%). Postoperative bleeding was encountered in one patient of each group (2%). The follow-up venous Doppler study was unremarkable in the two groups.

Conclusion

Apixaban was shown to be comparable to LMWH for the prevention of VTE after LSG with similar efficacy and safety making it a promising alternative to LMWH in patients undergoing bariatric surgery.