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LWMH Vs Apixban after LSG for chemoprophylaxis

Published in Surgery

Go to the profile of Ahmed Abdelsalam
Ahmed Abdelsalam
Assocaite Professor of General and Laparoscopic Surgery, Kasr Alainy Medical School, Cairo University
LWMH Vs Apixban after LSG for chemoprophylaxis
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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 - Obesity Surgery

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.

We are excited to share our latest research:
"Comparison Between Low Molecular Weight Heparin and Apixaban in the Prophylaxis Against Venous Thromboembolism After Laparoscopic Sleeve Gastrectomy"

🔍 Key Findings:
✔️ No venous thromboembolism (VTE) events occurred in either group.
✔️ Apixaban was found to be as effective and safe as low molecular weight heparin (LMWH) for post-bariatric surgery VTE prophylaxis.
✔️ Similar rates of postoperative bleeding (2%) in both groups.
✔️ The study highlights the potential advantages of DOACs in bariatric surgery, including ease of administration and non-requirement for monitoring.

💡 Why This Matters:
Venous thromboembolism is a serious postoperative risk in bariatric surgery, and anticoagulation strategies remain a critical area of research. Our randomized controlled trial (RCT) suggests that apixaban could be a viable alternative to LMWH, offering a simpler and potentially more patient-friendly approach to VTE prophylaxis.

📖 Read the full article here: DOI: 10.1007/s11695-025-07721-y

🔬 We welcome discussions, insights, and collaborations on the use of DOACs in bariatric surgery! Have you encountered similar findings in your practice? Let’s talk!

#BariatricSurgery #VTE #Anticoagulation #Apixaban #LMWH #ObesitySurgery #DOACs #PatientSafety #SurgicalResearch

Go to the profile of Ahmed Abdelsalam
Ahmed Abdelsalam (He/Him)
Assocaite Professor of General and Laparoscopic Surgery, Kasr Alainy Medical School, Cairo University

I am an Associate Professor of Surgery at Cairo University’s Kasr Al-Ainy Faculty of Medicine and a consultant bariatric and minimally invasive surgeon. My clinical work focuses on advanced laparoscopic and revisional bariatric procedures, managing a high-volume obesity surgery center. I am deeply involved in research, with multiple publications in leading journals such as Obesity Surgery, Surgical Endoscopy, and BMC Surgery, covering topics from revisional techniques to postoperative outcomes and innovation in metabolic surgery. I also serve as a reviewer for several international journals, contributing to maintaining scientific rigor and advancing surgical knowledge. Through both my clinical practice and academic work, I strive to improve patient outcomes and strengthen evidence-based bariatric care globally.

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