TY - JOUR
TI - Incidence, risk factors, and outcome of portal vein thrombosis after laparoscopic-assisted splenectomy in β-thalassemia patients: A prospective exploratory study
AU - Alexakis, N.
AU - Dardamanis, D.
AU - Albanopoulos, K.
AU - Ptohis, N.
AU - Skalistira, M.
AU - Karagiorga, M.
AU - Zografos, G.
AU - Leandros, E.
JO - Journal of Laparoendoscopic and Advanced Surgical Techniques
PY - 2013
VL - 23
TODO - 2
SP - 123-128
PB - 
SN - null
TODO - 10.1089/lap.2012.0268
TODO - warfarin, adult;  article;  beta thalassemia;  clinical article;  computer assisted tomography;  Doppler echography;  exploratory research;  female;  hand assisted laparoscopic splenectomy;  hand assisted laparoscopy;  high risk patient;  human;  hypersplenism;  incidence;  laparoscopic splenectomy;  laparoscopic surgery;  male;  portal vein thrombosis;  predictive value;  priority journal;  prognosis;  prospective study;  receiver operating characteristic;  risk factor;  spleen vein thrombosis;  spleen weight;  splenectomy;  splenic vein;  splenomegaly;  vein thrombosis, Adult;  beta-Thalassemia;  Female;  Humans;  Incidence;  Laparoscopy;  Male;  Portal Vein;  Prospective Studies;  Risk Factors;  Splenectomy;  Treatment Outcome;  Venous Thrombosis
TODO - Background: Portal vein system thrombosis (PVT) is an infrequent but potentially serious complication after laparoscopic splenectomy. Patients with β-thalassemia are at higher risk as they have splenomegaly and hypercoagulability. Subjects and Methods: Forty-eight β-thalassemia patients who underwent hand-assisted laparoscopic splenectomy or laparoscopic splenectomy were studied prospectively with pre- and postoperative Doppler ultrasonography or computed tomography scanning. Results: The incidence of PVT was 8.3% (95% confidence interval [CI] 0.2%-16.4%) (4 of 48 patients). Spleen weight was the only independent factor associated with the presence of PVT. The odds ratio for spleen weight (100 g increase) was 1.46 (95% CI 1.10-1.94, P=.010). Receiver operator characteristic curve analysis showed that the optimal cutoff of spleen weight to the prediction of PVT was 1543 g. Thrombosis resolution was observed after a median of 165 days. Conclusions: Patients with β-thalassemia who undergo laparoscopic-assisted splenectomy are at high risk of postoperative PVT. Close postoperative surveillance and aggressive coagulation prophylaxis are needed in these patients. Larger studies are required to confirm the present findings. © Mary Ann Liebert, Inc.
ER -