For the treatment of perioperative VTE in bariatric surgery, what is recommended?

Parenteral anticoagulation for the first 4 weeks is recommended in the context of perioperative venous thromboembolism (VTE) prevention in bariatric surgery for several important reasons. Bariatric surgery significantly increases the risk for VTE due to factors like decreased mobility post-operatively, changes in hemodynamics, and alterations in coagulation factors.

The use of parenteral anticoagulation ensures an effective and immediate action in preventing thrombus formation during the critical early postoperative period when patients are particularly vulnerable. This form of anticoagulation can include agents such as low molecular weight heparin (LMWH) or unfractionated heparin, which are standard protocols to mitigate VTE risks.

In contrast, options involving only the use of aspirin, immediate administration of direct oral anticoagulants (DOACs), or no intervention at all are less effective or not advisable in this high-risk group. Aspirin does not provide sufficient anticoagulation to prevent VTE in the perioperative setting. DOACs, while effective for certain conditions, are not typically recommended immediately post-surgery due to variable absorption and an increased risk of bleeding. Lastly, failing to use any anticoagulation is associated with significantly heightened risks of