Postoperative portomesenteric venous thrombosis: lessons learned from 1,069 consecutive laparoscopic colorectal...

Area of Science:

• Gastroenterology
• Vascular Surgery
• Surgical Complications

Background:

• Portomesenteric venous thrombosis (PVT) is a recognized complication following colorectal surgery.
• Risk factors and prognosis for PVT remain incompletely understood.

Purpose of the Study:

• To identify predictors of symptomatic postoperative PVT.
• To describe the clinical course and outcomes of PVT after colorectal surgery.

Main Methods:

• Retrospective analysis of a prospectively collected database of 1,069 patients undergoing LCR surgery.
• Multivariate analysis to determine independent predictors of PVT.
• Evaluation of patients with new-onset postoperative abdominal pain using CT scans.

Main Results:

• 3.5% of patients developed symptomatic PVT.
• Total proctocolectomy (TPC) and postoperative intraabdominal septic complications were independent predictors of PVT.
• PVT patients had longer hospital stays; 72.7% had hypercoagulable conditions.

Conclusions:

• TPC and postoperative sepsis increase PVT risk, especially in patients with coagulation disorders.
• Prompt diagnosis and 6-month oral anticoagulation are recommended.
• No PVT-related deaths or complications were observed with this management approach.