title: Incidence, risk factors, and outcome of portal vein thrombosis after laparoscopic-assisted splenectomy in β-thalassemia patients: a prospective exploratory study.
abstract: 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.
  
  
  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.
authors: Department of Surgery, University of Athens, Hippocratio Hospital, Athens, Greece. nalexak@med.uoa.gr
authors: Nicholas
authors: N
authors: Alexakis
authors: Dimitrios
authors: D
authors: Dardamanis
authors: Konstandinos
authors: K
authors: Albanopoulos
authors: Nikolaos
authors: N
authors: Ptohis
authors: Maria
authors: M
authors: Skalistira
authors: Markisia
authors: M
authors: Karagiorga
authors: George
authors: G
authors: Zografos
authors: Emmanuel
authors: E
authors: Leandros
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D011169:Portal Vein; D011446:Prospective Studies; D012307:Risk Factors; D013156:Splenectomy / Q000009:adverse effects* / Q000379:methods*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000453:epidemiology* / Q000209:etiology*; D017086:beta-Thalassemia / Q000150:complications*