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Subclinical Deep Vein Thrombosis; Role of Color Doppler Ultrasonography before Bariatric Surgery
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Naser Malekpour Alamdari1    , Karo Servatyari2 , Khaled Rahmani3 , Ataollah Mohammadi 4 |
1- Professor, Critical Care Quality Improvement Research Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2- MD Student, Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
3- Assistant professor, Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
4- Department of Surgery, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran. , mohammadiata333@yahoo.com |
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Abstract: (801 Views) |
Background and Aim: Obesity increases risk of venous thromboembolism due to increase in coagulation factors. Screening for deep vein thrombosis (DVT) before bariatric surgery can minimize the incidence of venous thromboembolism (VTE) in these patients. This study aimed to determine the importance of color Doppler ultrasound before bariatric surgery to detect subclinical deep vein thrombosis in the patients.
Materials and Methods: This was a descriptive cohort study. The study population included candidates for bariatric surgery admitted to Modares and Loghman hospitals in Tehran (a bariatric surgery center in Iran) between March-20 and September-20, 2021. Patients were followed up for 30 days after surgery. Census sampling was used. Data were finally entered into SPSS-23 statistical software and analyzed by descriptive tests.
Results: Among 125 patients in this study, 85 (64%) were woman. The patient’s mean and standard deviation of age and Body Mass Index were 33.68 ± 6.8 and 43.15 ± 4.9, respectively. Before surgery, all patients were evaluated for subclinical DVT and the results of the study showed that none of the patients had any evidence in favor of DVT. After the surgery, the patients underwent regular follow-ups for a month, but no positive cases of deep vein thrombosis were reported.
Conclusion: In our study thromboembolic problems were rare in patients before obesity surgery. Therefore, routine ultrasound examination before surgery does not seem reasonable.
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| Keywords: Bariatric surgery, Color Doppler Ultrasonography, Thrombophlebitis, Obesity |
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Full-Text [PDF 612 kb]
(147 Downloads)
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Type of Study: Original Research |
Subject:
Medicine - General Surgery
Received: 2022/01/16 | Accepted: 2022/03/19 | Published: 2023/07/31
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| References |
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Raj PP, Gomes RM, Kumar S, Senthilnathan P, Parathasarathi R, Rajapandian S, et al. Role of routine pre-operative screening venous duplex ultrasound in morbidly obese patients undergoing bariatric surgery. J Minim Access Surg. 2017;13(3):205-7. [ DOI:10.4103/jmas.JMAS_199_15] [ PMID] [ ] 23. Prystowsky JB, Morasch MD, Eskandari MK, Hungness ES, Nagle AP. Prospective analysis of the incidence of deep venous thrombosis in bariatric surgery patients. Surgery. 2005;138(4):759-65. [ DOI:10.1016/j.surg.2005.07.024] [ PMID] 24. Bhattacharya S, Kumar SS, Swamy PDK, Palanivelu C, Raj PP. Deep vein thrombosis prophylaxis: Are we overdoing? An Asian survey on trends in bariatric surgery with a systematic review of literature. J Minim Access Surg. 2018;14(4):285-90. [ DOI:10.4103/jmas.JMAS_151_17] [ PMID] [ ] 25. Abel EJ, Wong K, Sado M, Leverson GE, Patel SR, Downs TM, et al. Surgical operative time increases the risk of deep venous thrombosis and pulmonary embolism in robotic prostatectomy. J Soc Laparoendosc Surg. 2014;18(2):282-7. [ DOI:10.4293/JSLS.2014.00101] [ ] 26. Skinner AC, Ravanbakht SN, Skelton JA, Perrin EM, Armstrong SC. Prevalence of obesity and severe obesity in US children, 1999-2016. Pediatrics. 2018;141(3):1116-23. [ DOI:10.1542/peds.2017-3459] [ PMID] [ ] 27. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity among adults and youth: United States, 2015-2016. Nat Center Health Statistics. 2017.;288:1-8. 28. Sarokhani D, Sarokhani M, Dehkordi AH, Gheshlagh RG, Fakhri M. Prevalence of obesity and overweight in Iranian students: a systematic review and meta-analysis. J Pediatr Endocrinol Metab. 2020;33(4):453-68. [ DOI:10.1515/jpem-2019-0474] [ PMID] 29. Lu Y, Hajifathalian K, Ezzati M, Woodward M, Rimm EB, Danaei G. Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1• 8 million participants. Lancet (London, England). 2013;383(9921):970-83. [ DOI:10.1016/S0140-6736(13)61836-X] [ PMID] 30. Reaven GM. Pathophysiology of insulin resistance in human disease. Physiol Rev. 1995;75(3):473-86. [ DOI:10.1152/physrev.1995.75.3.473] [ PMID] 31. Martins LM, Oliveira ARS, Cruz KJC, Torres-Leal FL, Marreiro DdN. Obesity, inflammation, and insulin resistance. Braz J Pharm Sci. 2014;50(4):677-92. [ DOI:10.1590/S1984-82502014000400003] 32. Dentali F, Squizzato A, Ageno W, editors. The metabolic syndrome as a risk factor for venous and arterial thrombosis. Seminars in thrombosis and hemostasis; 2009. Thieme Medical Publishers. InSeminars in Thrombosis and Hemostasis. 2009;35(5): 451-7. [ DOI:10.1055/s-0029-1234140] [ PMID] 33. Vallis M. Quality of life and psychological well‐being in obesity management: improving the odds of success by managing distress. Int J Clin Pract. 2016;70(3):196-205. [ DOI:10.1111/ijcp.12765] [ PMID] [ ] 34. Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;74(10):1376-414. [ DOI:10.1016/j.jacc.2019.03.009] [ PMID] [ ] 35. Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E. 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJ. 2007;176(8):S1-S13. [ DOI:10.1503/cmaj.061409] [ PMID] [ ] 36. Heymsfield SB, Wadden TA. Mechanisms, pathophysiology, and management of obesity. N Engl J Med. 2017;376(3):254-66. [ DOI:10.1056/NEJMra1514009] [ PMID] 37. Chang S-H, Stoll CR, Song J, Varela JE, Eagon CJ, Colditz GA. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003-2012. JAMA Surg. 2014;149(3):275-87. [ DOI:10.1001/jamasurg.2013.3654] [ PMID] [ ] 38. Finks JF, English WJ, Carlin AM, Krause KR, Share DA, Banerjee M, et al. Predicting risk for venous thromboembolism with bariatric surgery: results from the Michigan Bariatric Surgery Collaborative. Ann Surg. 2012;255(6):1100-4. [ DOI:10.1097/SLA.0b013e31825659d4] [ PMID] 39. Pandey A, Thakur B, Hogg F, Brogna C, Logan J, Arya R, et al. The role of preoperative deep vein thrombosis screening in neurooncology. J Neurosurg. 2018;130(1):38-43. [ DOI:10.3171/2017.9.JNS17176] [ PMID] 40. Winegar DA, Sherif B, Pate V, DeMaria EJ. Venous thromboembolism after bariatric surgery performed by Bariatric Surgery Center of Excellence Participants: analysis of the Bariatric Outcomes Longitudinal Database. Surg Obes Relat Dis. 2011;7(2):181-8. [ DOI:10.1016/j.soard.2010.12.008] [ PMID] 41. Kruger PC, Eikelboom JW, Douketis JD, Hankey GJ. Deep vein thrombosis: update on diagnosis and management. Med J Aust. 2019;210(11):516-24. [ DOI:10.5694/mja2.50201] [ PMID] 42. Cummings DE, Rubino F. Response to Comment on Rubino et al. Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations. Diabetes Care 2016 [ DOI:10.2337/dci16-0031] [ PMID] 43. 39: 861-877. Diabetes Care. 2016;39(11):e202-e3. [ DOI:10.2337/dci16-0031] [ PMID] 44. Stein PD, Beemath A, Olson RE. Obesity as a risk factor in venous thromboembolism. Am J Med. 2005;118(9):978-80. [ DOI:10.1016/j.amjmed.2005.03.012] [ PMID] 45. Darvall K, Sam R, Silverman S, Bradbury A, Adam D. Obesity and thrombosis. Eur J Vasc Endovasc Surg.2007;33(2):223-33. [ DOI:10.1016/j.ejvs.2006.10.006] [ PMID] 46. Pannacciulli N, De Mitrio V, Marino R, Giorgino R, De Pergola G. Effect of glucose tolerance status on PAI‐1 plasma levels in overweight and obese subjects. Obes Res. 2002;10(8):717-25. [ DOI:10.1038/oby.2002.98] [ PMID] 47. Raj PP, Gomes RM, Kumar S, Senthilnathan P, Parathasarathi R, Rajapandian S, et al. Role of routine pre-operative screening venous duplex ultrasound in morbidly obese patients undergoing bariatric surgery. J Minim Access Surg. 2017;13(3):205-7. [ DOI:10.4103/jmas.JMAS_199_15] [ PMID] [ ] 48. Prystowsky JB, Morasch MD, Eskandari MK, Hungness ES, Nagle AP. Prospective analysis of the incidence of deep venous thrombosis in bariatric surgery patients. Surgery. 2005;138(4):759-65. [ DOI:10.1016/j.surg.2005.07.024] [ PMID] 49. Bhattacharya S, Kumar SS, Swamy PDK, Palanivelu C, Raj PP. Deep vein thrombosis prophylaxis: Are we overdoing? An Asian survey on trends in bariatric surgery with a systematic review of literature. J Minim Access Surg. 2018;14(4):285-90. [ DOI:10.4103/jmas.JMAS_151_17] [ PMID] [ ] 50. Abel EJ, Wong K, Sado M, Leverson GE, Patel SR, Downs TM, et al. Surgical operative time increases the risk of deep venous thrombosis and pulmonary embolism in robotic prostatectomy. J Soc Laparoendosc Surg. 2014;18(2):282-7. [ DOI:10.4293/JSLS.2014.00101] [ ] |
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Ethics code: IR.SBMU.RETECH.REC.1399.1356
Malekpour Alamdari N, Servatyari K, Rahmani K, Mohammadi A. Subclinical Deep Vein Thrombosis; Role of Color Doppler Ultrasonography before Bariatric Surgery. SJKU 2023; 28 (3) :48-57 URL: http://sjku.muk.ac.ir/article-1-7184-en.html
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