Therapeutic Effect of Low-Molecular Weight Heparin and Incidence of Lower Limb Deep Venous Thrombosis and Pulmonary Embolism After Laparoscopic Bariatric Surgery

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(2). 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.