Portomesenteric Venous Thrombosis after Colorectal Surgery: A Retrospective Study

Abstract

CONTEXT: Postoperative Portomesenteric venous thrombosis (PMVT), is a rare but significant condition that occurs in colorectal surgery patients. PMVT involves thrombus formation in veins such as the portal, superior mesenteric, inferior mesenteric, or splenic vein, often following colon and rectum surgical resection. Recognized risk factors include cancer and inflammatory bowel disease. AIMS: The research aimed to evaluate the prevalence, associated risk factors, and treatment methods for PMVT in a large academic tertiary care hospital. SETTINGS AND DESIGN: Retrospective review METHODS: A retrospective review of 750 colorectal surgeries was conducted, examining patient medical histories, operative details, perioperative medications, and postoperative complications. STATISTICAL ANALYSIS USED: Categorical variables were presented as frequencies and percentages, whereas continuous variables were presented as a mean +/- Standard deviation. Comparative analysis used odds ratios to understand the association between categorical risk factors and PMVT, and independent samples t-tests for continuous variables RESULTS: PMVT was identified in 0.8% of the 621 patients meeting the inclusion criteria, all of whom had underlying cancer. These patients were successfully treated with anticoagulants, without the need for surgery or resulting in any mortality at 45 days postoperatively. No significant variables associated with PMVT were identified in this cohort. CONCLUSIONS: PMVT after colorectal surgery, while rare, is predominantly seen in patients with cancer. The outcomes in these cases were favorable with medical therapy alone. Larger, long-term studies are recommended to further investigate risk factors and effective management strategies for PMVT.

Keywords

• colorectal cancer
• colorectal surgery
• portal vein thrombus
• thromboembolic disease
• venous thromboembolism