Background: Deep vein thrombosis remains an important health care problem as it is related with the complications having high morbidity and mortality rate. It is considered the third most common acute cardiovascular disease after ischemic heart disease and stroke and effects millions of people worldwide. The aim of this study was to evaluate the rate of deep vein thrombosis (DVT) in patients undergoing laparoscopic fundoplication in two different prophylactic regimes and propose the best. To estimate the sensitivity and specificity of ultrasound (US) for the diagnosis of deep vein thrombosis (DVT) of proximal and distal leg veins.
Materials and methods: The study was performed on 121 patients who were randomized into two groups. All the patients received intermittent pneumatic compression during the laparoscopic fundoplications. The first group received low molecular weight heparin 12 h before the operation, 6 and 30 h after it. The second group received low molecular weight heparin only 1 h before the laparoscopic fundoplication. All the patients underwent color duplex scan examination preoperatively and spiral CT venography with US scan on the third postoperative day to determine the presence and location of deep vein thrombosis.
Results: CT venography revealed posterior tibial vein thrombosis in two (3.3%) I group patients. The sensitivity and specificity of US in our study for femoropopliteal DVT, as compared with CT venography, were both 100% and for inferopopliteal DVT – sensitivity and specificity 98%.
Conclusions: US is highly sensitive and specific noninvasive imaging option for evaluation of proximal DVT, and it is less accurate for the calf veins. The better anticoagulation effect was obtained when low molecular weight heparin was administered 1 hour before the laparoscopic fundoplication.