PREVENTION OF THROMBOEMBOLIC COMPLICATIONS IN A PATIENT WITH MORBID OBESITY AFTER BARIATRIC SURGERY
DOI:
https://doi.org/10.32782/2411-9164.21.2-3Keywords:
morbid obesity, bariatric surgery, venous thromboembolism (VTE), thromboembolism prevention, sodium enoxaparin, pentoxifylline, thromboelastography, hemostasis, clinical case, anticoagulant therapyAbstract
The report presents a clinical case of a patient with morbid obesity who underwent bariatric surgery for weight reduction. The assessment of the patient’s condition revealed an increased risk of venous thromboembolism (VTE) due to comorbidities such as arterial hypertension and type II diabetes. Both pharmacological and non-pharmacological measures were implemented for the prevention of thromboembolic complications, including sodium enoxaparin and pentoxifylline, as well as active rehabilitation treatment. During the postoperative observation of the patient, low-frequency piezoelectric thromboelastography revealed that the combined treatment significantly reduced the risk of VTE. The results confirmed the necessity of an individualized approach to the prevention of thromboembolic complications in patients with morbid obesity. The report emphasizes the importance of a comprehensive approach to thromboembolism prevention, as well as the role of thromboelastography in hemostasis monitoring in clinical practice. The conclusions indicate the need for the development of specialized prevention protocols for patients at high risk.
References
World health statistics. 2012. Pp. 34–37.
Flegal, K.M. (2010). Prevalence and trends in obesity among US adults, 1999–2008 / K.M. Flegal, M.D. Carroll, C.L. Ogden, L.R. Curtin. JAMA. Vol. 303. P. 235–241.
Faber, D.R. (2009). Role of adipose tissue in haemostasis, coagulation and fibrinolysis. / D.R. Faber, P.G. de Groot, F.L. Visseren. Obes Rev. Vol. 10. P. 554–563.
David, A., & Froehling, M.D. (2014). Incidence of Venous Thromboembolism After Bariatric Surgery: A Population-Based Cohort Study. / David A. Froehling, Paul R. Daniels, Karen F. Mauck, Maria L. Collazo-Clavell, Aneel A. Ashrani, Michael G. Sarr, Tanya M. Petterson, Kent R. Bailey. NIH Public Access. Obes Surg. Author manuscript; available in PMC. February 14. Р. 1–5.
Flum, D.R, & Belle, S.H. (2009). Longitudinal Assessment of Bariatric Surgery (LABS) Consortium. Perioperative safety in the longitudinal assessment of bariatric surgery. / Flum D.R., Belle S.H., King W.C., Wahed A.S., Berk P., Chapman W., et al. N Engl J Med. Jul 30. 361(5):445–54. [PubMed: 19641201].
Lancaster, R.T, & Hutter, M.M. (2008). Bands and bypasses: 30-day morbidity and mortality of bariatric surgical procedures as assessed by prospective, multi-center, risk-adjusted ACS-NSQIP data. Surg Endosc. 2008 Dec; 22(12):2554–63. Epub 2008 Sep 20. [PubMed: 18806945].
Winegar, D.A. (2011). Venous thromboembolism after bariatric surgery performed by Bariatric Surgery Center of Excellence Participants: analysis of the Bariatric Outcomes Longitudinal Database. / Winegar D.A., Sherif B., Pate V., DeMaria E.J. Surg Obes Relat Dis. Mar–Apr. 7(2):181–8. Epub 2010 Dec 29. [PubMed: 21421182].
Spyropoulos, A.C. (2005). Emerging strategies in the prevention of venous thromboembolism in hospitalized medical patients. Chest. 128:958–969.
Eleni, Zachari, & Eleni, Sioka. (2012). Venous Thromboembolism in Bariatric Surgery. / Eleni Zachari, Eleni Sioka, George Tzovaras and Dimitris Zacharoulis Dr. Ufuk Çobanoğlu (Ed.). ISBN: 978-953-51-0233-5.
Flegal, K.M. (2010). Prevalence and trends in obesity among US adults, 1999–2008. / K.M. Flegal, M.D. Carroll, C.L. Ogden, L.R. Curtin. JAMA. Vol. 303. P. 235–241.
Faber, D.R. (2009). Role of adipose tissue in haemostasis, coagulation and fibrinolysis / D.R. Faber, P.G. de Groot, F.L. Visseren. Obes Rev. Vol. 10. P. 554–563.
David, A., & Froehling, M.D. (2014). Incidence of Venous Thromboembolism After Bariatric Surgery: A Population-Based Cohort Study. / David A. Froehling, Paul R. Daniels, Karen F. Mauck, Maria L. Collazo-Clavell, Aneel A. Ashrani, Michael G. Sarr, Tanya M. Petterson, Kent R. Bailey. NIH Public Access. Obes Surg. Author manuscript; available in PMC. February 14. Р. 1–5.
