Venous thromboembolism (VTE) is a major cause of morbidity and mortality after bariatric surgery.
We designed a survey to study VTE after bariatric surgery in the Middle East & North Africa region (MENA). We used Survey Monkey and uploaded the survey in our PASMBS social media platforms.
Eighty-two surgeons (63%) responded, they performed 121,369 cases and encountered 230 VTEs (0.19%). VTEs included 13 upper extremity, 103 lower extremity, 57 pulmonary embolism (PE), and 57 porto-mesenteric venous thrombosis (PMT). There was 9 VTE related mortalities constituting 4% mortality rate. The most commonly performed procedure was Sleeve Gastrostomy (56%). It was followed by Adjustable Gastric band (13%), One Anastomosis Gastric Bypass (10%), and Roux-en-Y Gastric bypass (9%). A scoring tool for VTE was used by 62% of surgeons and Caprini was the most commonly used tool and 62% of surgeons reported having at least one incident of VTE. Sequential compression devices were used by 57% of surgeons. Low molecular weight heparin was the most commonly used chemoprophylaxis. LMWH 40 mg once a day was used in 53% of the moderate risk group, 26% of the high-risk group and 6% in the highest risk group. Post-discharge, chemoprophylaxis was continued in the moderate, high and highest risk patients 82%, 95%, and 98% respectively.
VTE risk assessment and the use of chemoprophylaxis for VTE is common in the MENA region. However, many patients continue to receive sub-therapeutic doses of low molecular heparin during the hospital stay and after discharge.