Prospective Study of the Incidence and Risk Factors of Postsplenectomy Thrombosis of the Portal, Mesenteric, and Splenic Veins

Stamou, Konstantinos M.; Toutouzas, Konstantinos G.; Kekis, Panagiotis; Nakos, Socrates; Gafou, A.; Manouras, Andreas; Krespis, Eustathios; Katsaragakis, Stylianos; Bramis, John

doi:10.1001/archsurg.141.7.663

Cited by 175 publications

(120 citation statements)

References 38 publications

Supporting

Mentioning

115

Contrasting

Unclassified

Order By: Relevance

“…The incidence of SPVT after splenectomy was evaluated prospectively with different imaging methods in ten studies, five after OS [8][9][10][11]15 and five after LS. 12,13,16,17,18 Contrast-enhanced computerized tomography (CT) was used by two studies of the same authors 8,17 and color Doppler imaging in the remaining studies.…”

Section: Resultsmentioning

confidence: 99%

“…The time schedule for monitoring was not identical in these series and ranged from one single examination between days 3 and 11 8,17 to two or more examinations (days 7, 30 and later). 9,11,12 The patients were extremely heterogeneous with regard to the underlying diseases.…”

Section: Resultsmentioning

confidence: 99%

“…30 In studies with evaluation of symptomatic DVT/PE, the incidence was 1.6% (7/433). 9,13,25,31 It is uncertain whether in studies in which DVT/PE was not mentioned 11,12,21,24 the incidence was zero or if the incidence was not specifically evaluated. To date, it is impossible, from the available data, to draw any specific conclusions on the occurrence and prevention of DVT/PE after splenectomy.…”

Section: Incidence Of Deep Venous Thrombosis And/or Pulmonary Embolismentioning

confidence: 99%

“…9,12,21,24 The duration of heparin prophylaxis ranged from three to more than seven days after surgery. In only a few studies 9,11,24,25,30 was heparin treatment extended beyond seven days in some of the patients.…”

Section: Antithrombotic Prophylaxismentioning

confidence: 99%

“…Only a few of these studies specifically addressed the problem of postoperative SPVT [5][6][7][8][9][10][11][12][13] or DVT/PE.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The postoperative splenic/portal vein thrombosis after splenectomy and its prevention - an unresolved issue

Krauth¹,

Lechner²,

Neugebauer³

et al. 2008

Haematologica

115

View full text Add to dashboard Cite

Patients undergoing splenectomy have an increased risk of splenic/portal vein thrombosis. We used several databases to identify publications dealing with this risk and analyzed incidence, risk factors and outcome. The risk of splenic portal vein thrombosis has been addressed in prospective and retrospective randomized or non-randomized studies. All studies combined, the overall risk is 3.3%. Risk factors are big spleens (i.e. myeloproliferative disorders) and hereditary hemolytic anemias, whereas the risk is low in autoimmune thrombocytopenia and trauma. The incidence is approximately the same in laparascopic and open splenectomy. The median time from splenectomy to symptomatic splenic vein thrombosis is 8-12 days. Postoperative antithrombotic prophylaxis ranged from no prophylaxis to heparin for seven days or longer. Treatment of symptomatic splenic vein thrombosis with heparin and warfarin leads to complete resolution of thrombosis in 67%, to partial resolution in 13%, but persistent occlusion, portal hypertension or cavernoma occurred in 20%. The long-term outcome of treatment failures is unknown. Well-designed randomized studies on the prophylaxis of venous thromboembolism after splenectomy are urgently needed.Key words: portal vein thrombosis, risk factors, splenectomy, thromboembolism, treatment. Citation: Krauth M-T, Lechner K, Neugebauer EAM and Pabinger I. The postoperative splenic/portal vein thrombosis after splenectomy and its prevention -an unresolved issue.

show abstract