Trombose venosa pós cirurgia bariátrica, incidência e protocolos de profilaxia. revisão sistemática

The challenge in adopting prophylactic measures in thrombosis events, especially in bariatric surgeries, is explained by the low number of data that limit the elaboration of robust and evidenced guidelines. Thromboprophylaxis is a significant way to reduce mortality or disabling syndromes, such as chronic edema and ulcerations in the lower limbs. Given the lack of specific protocols in bariatric surgeries, records of abdominopelvic surgeries suggest extended prophylaxis. Analyzing risk factors and patient parameters are important determinants in reducing morbidity and mortality, in addition to the best direction for adequate conduct for each patient. All articles surveyed here sought a way to mark out a thromboprophylactic protocol and its ability to function. Based on this foundation, 1157 patients had some type of thrombosis, whether portomesenteric thrombosis, portosplenomesenteric thrombosis or pulmonary thromboembolism, totaling 0.4% of the patients studied. The survey mostly demonstrates the use of heparins (UFH and LMWH) with action on the coagulation cascade, often associated with mechanical methods that avoid blood stasis and endothelial injury. Thrombotic events do not cease to occur in some cases, represented by a small portion, although they may be related to previous comorbidities. Therefore, the multimodal conducts for evaluating the patient from admission to the service, use of validated tools added to the best prophylactic choice, bring positive impacts in the prevention of thrombi in patients undergoing gastrectomy.