Portal Vein Thrombosis After Laparoscopic Sigmoid Colectomy for Diverticulitis

Baixauli, Jorge; Delaney, Conor P.; Senagore, Anthony J.; Remzi, Feza H.; Fazio, Victor W.

doi:10.1007/s10350-004-6599-9

Cited by 33 publications

(20 citation statements)

References 22 publications

(28 reference statements)

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“…In our study, a significant difference was not determined regarding D-Dimer, while fibrinogen values which were higher than the control group caused a hyper-coagulable state. In a patient who was normal before the surgery and then undergone laparoscopic sigmoid colectomy for diverticulitis, portal vein thrombosis was reported following surgery and protein S value was found to be lower [4]. Also in our study, a statistically significant decrease occurred in protein S values (p \ 0.05).…”

Section: Discussionsupporting

confidence: 63%

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The Effect of Carbon Dioxide Insufflation Applied at Different Pressures and Periods on Thrombotic Factors

Sen

Türkyılmaz

Sönmez

et al. 2015

Indian J Hematol Blood Transfus

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The aim of this experimantal study which is applied on rats, is to determine the differences on the clotting factors over the application of low and high intraabdominal pressure (IAP) values in different periods of time in carbon dioxide (CO 2 ) pneumoperitoneum. Thirty rats were randomized into five groups (n = 6): a control group (Group K) and 1 h and 6 mm Hg IAP (Group A), 2 h and 6 mm Hg IAP (Group B), 1 h and 12 mm Hg IAP (Group C) and 2 h and 12 mm Hg IAP were created with CO 2 pneumoperitoneum (Group D). At the end of the experiment, plasma samples taken from subjects and fibrinogen, FII (prothrombin), FV, FVII, FVIII, FIX, FX, FXI, FXII, von willebrand's factor (vWF), ristocetin cofactor, protein C, protein S, antithrombin III (AT III) levels are studied. There were statistically significant differences in the mean levels of FII, FV, FVII, FVIII, FIX, FX, FXI, FXII, and protein S between the groups. A hypercoagulable state occurred with the following: increase in the coagulation parameters compared to the control group; increase in FVII in the group only Group C; decrease in AT III in all groups compared to the control group; decrease in protein C in the group only XII Group D compared to control group; decrease in protein S in all groups except group D compared to control group. CO 2 insufflation predisposes to thromboembolic events both by inducing coagulation factors and by suppressing the fibrinolytic system contrary to the controversies in the literature.

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Section: Discussionsupporting

confidence: 63%

“…Increase in IAP caused by PP leads to an increase in venous blood pressures while it results in reduction of vena cava inferior flow and venous return in lower extremities [3]. Also, reduced splanchnic circulation improves after desufflation and reperfusion injury occurred in vessel endothelium initiates thrombus formation [3,4].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Carbon Dioxide Insufflation Applied at Different Pressures and Periods on Thrombotic Factors

Sen

Türkyılmaz

Sönmez

et al. 2015

Indian J Hematol Blood Transfus

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“…Changes in intra-abdominal pressure during splenectomy reduce portal vein blood flow and induce stasis. Both stases of venous flow and resulting congested coagulation factors may induce PSVT, as reported by Baixauli et al 57 Our study shows that the two major differences between LS and OS within the operative technique 46 were pneumoperitoneum and ligation of splenic hilar vessels. In the OS group, splenic hilar vessels were legated conventionally, and the structures were divided close to the splenic parenchyma with an endoscopic vascular stapler or with the LigaSure vessel sealings during LS.…”

supporting

confidence: 56%

The implications for patients undergoing splenectomy: postsurgery risk management

Romano

Garancini²,

Ciravegna³

et al. 2011

OAS

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Splenectomy has been performed for a heterogeneous group of hematologic diseases with a therapeutic or diagnostic purpose or as part of the staging process in Hodgkin's disease. Most patients undergoing therapeutic splenectomy are chronically ill with significant splenomegaly. This scenario can be associated with a high risk of postoperative morbidity and mortality due to the prolonged course of disease for patients with myelofibrosis; their susceptibility to infection, thrombosis, and hemorrhage; and the severe enlargement of their spleens. We have reviewed the main papers published about postoperative complications after splenectomy, analyzing the risk factors, prevention measures, and respective treatments. Great care must be taken in the management of patients presenting malignant diseases, splenomegaly, and hemostasis disorder. Moreover, despite the faster discharge that new surgical techniques now allow, close attention should be paid to symptoms reported by patients, in order to avoid potentially life-threatening complications such as portal vein thrombosis, pancreas injuries, and overwhelming postsplenectomy infection.

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“…The issue of conversion is especially crucial in the obese patient population where frequently the transverse colon or terminal ileum cannot be easily exteriorized due to a short and heavy mesentery and a thick abdominal wall. Furthermore, undue traction on the mesentery may lead to vascular complications including mesenteric and portal vein thrombosis [22] or bleeding. These technical limitations in the right colon resection of obese patients increase the likelihood of converting an EA technique to a fully open resection.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic right hemicolectomy: short- and long-term outcomes of intracorporeal versus extracorporeal anastomosis

et al. 2015

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Background The use of laparoscopy for right hemicolectomy has gained popularity allowing the option of a totally laparoscopic intracorporeal anastomosis (IA) for intestinal reconstruction. This technique may alleviate some of the technical limitations that a surgeon faces with a laparoscopic-assisted extracorporeal anastomosis (EA). Results A total of 195 patients underwent laparoscopic right hemicolectomy over the study period, with 86 (44 %) patients receiving IA and 109 (56 %) patients receiving an EA. The most common indication for surgery in both groups was cancer: 56 (65 %) of IA cases and 57 (52 %) of EA cases. IA had a significantly higher rate of minor complications but no difference in serious complications compared to EA. Conversion to open resection was higher in EA. Using multivariate analysis to compare IA versus EA, there was no significant difference in length of stay, return of bowel function, risk of anastomotic leak, risk of intraabdominal abscess or risk of wound complications. Amongst cancer resections, there was no significant difference in the median number of lymph nodes harvested (18 LNs in IA group vs. 19 LNs in EA group, P > 0.05). There was also no significant difference in overall survival and disease-free survival at 5.7 years between the two groups. MethodsConclusions IA in laparoscopic right hemicolectomy is associated with similar postoperative and oncologic outcomes compared to EA. IA may possess advantages in terms of conversion and flexibility of specimen extraction, but this is counterbalanced by a higher incidence of minor complications. These findings suggest that IA represents a valid technique in the arsenal of the experienced colorectal surgeon without compromising outcomes.

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Portal Vein Thrombosis After Laparoscopic Sigmoid Colectomy for Diverticulitis

Cited by 33 publications

References 22 publications

The Effect of Carbon Dioxide Insufflation Applied at Different Pressures and Periods on Thrombotic Factors

The Effect of Carbon Dioxide Insufflation Applied at Different Pressures and Periods on Thrombotic Factors

The implications for patients undergoing splenectomy: postsurgery risk management

Laparoscopic right hemicolectomy: short- and long-term outcomes of intracorporeal versus extracorporeal anastomosis

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