Prophylactic enoxaparin use and outcomes in obese patients undergoing laparoscopic adjustable gastric band surgery

There is a lack of clear guidance for the prophylactic use of anticoagulants for patients undergoing laparoscopic adjustable gastric banding (LAGB) surgery. This study aimed to evaluate the risk of venous thromboembolism (VTE), prophylactic use of enoxaparin and clinical outcomes in patients undergoing primary and revisional LAGB procedures. A retrospective cohort study evaluated the prophylactic use of enoxaparin in adult patients who underwent primary and revisional (band and port) LAGB procedures. The incidence of VTE and major bleeding was investigated during a 90-day follow-up period. We included 112 and 100 patients who had undergone primary and revisional LAGB surgery, respectively. The majority of patients (97%) had a mild risk of VTE development using a post-discharge VTE risk calculator tool published from the Cleveland Clinic. Overall, 69% patients received standard enoxaparin dose i.e 40 mg once daily. All primary procedure patients received prophylactic enoxaparin, compared to 79% and 20% of revisional patients who underwent band and port procedures, respectively. Use of enoxaparin was more common in patients admitted overnight. The overall VTE incidence after 90 days was 0.9%, and no major bleeding events were observed. Obese patients received standard 40 mg daily dose of enoxaparin. No higher doses was given to obese patients, likely because LAGB is low risk surgical procedure.