Τίτλος:
Incidence, risk factors, and outcome of portal vein thrombosis after laparoscopic-assisted splenectomy in β-thalassemia patients: A prospective exploratory study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Alexakis, N.
Dardamanis, D.
Albanopoulos, K.
Ptohis, N.
Skalistira, M.
Karagiorga, M.
Zografos, G.
Leandros, E.
Περιοδικό:
Journal of Laparoendoscopic and Advanced Surgical Techniques
Λέξεις-κλειδιά:
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
DOI:
10.1089/lap.2012.0268
