Published in:
01-09-2015 | Original Contributions
The Safety of Laparoscopic Sleeve Gastrectomy in Patients Receiving Chronic Anticoagulation Therapy: A Case-Matched Study
Published in: Obesity Surgery | Issue 9/2015
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Background
Obesity is linked to cardiac disorders with a relative risk of atrial fibrillation of 1.5 (requiring the use of chronic anticoagulation therapy, CAT). However, CAT is a known risk factor for postoperative bleeding after elective surgery. The primary objective of the present study was to evaluate the short- and long-term complications of laparoscopic sleeve gastrectomy (LSG) in patients receiving CAT.
Methods
This is a retrospective analysis of a prospective database of CAT patients undergoing LSG between March 2004 and December 2012. This LSG-CAT group was matched 1:2 on preoperative data with patients not receiving CAT (LSG-control group). Primary efficacy criterion was the frequency of CAT-related complications. Secondary efficacy criteria were the major postoperative complications, frequency of revisional surgery, long-term CAT-related complications, and a change in the dose level of oral anticoagulants.
Results
The LSG-CAT group consisted of 15 patients with a median age of 54 years (32–65). The LSG-control group consisted of 30 patients. Median operating time was 75 min in both groups (p = 0.33). Major complication rates in the LSG-CAT and LSG-control groups were 13.3 and 3.3 %, respectively (p = 0.20), with one case of postoperative bleeding in each group (6.7 and 3.3 %, p = 0.6); incidence of revisional surgery was 13.3 and 3.3 % (p = 0.2). There were no postoperative mortalities. After a median follow-up of 14 months (9–43), no changes in the dose level of oral anticoagulants were reported.
Conclusions
LSG in patients receiving CAT is not associated with CAT-specific complications. This surgical procedure enables good weight loss and does not require change in the dose level of oral anticoagulants.