title: Portomesenteric vein thrombosis after gastric surgery.
abstract: BACKGROUND
  Postoperative portomesenteric venous thrombosis (PMVT) is a rare but potentially serious complication of gastric surgery. This study analyzed the incidence, characteristics, risk factors, and outcomes of PMVT following gastric surgery.
  
  
  METHODS
  Medical records of patients who underwent gastric surgery between January 2007 and December 2012 were reviewed retrospectively. The risk factors of PMVT were analyzed by a logistic regression analysis with control group matched 1:4 by age, sex, and cancer stage and by a Poisson regression analysis with unmatched control group. The resolution rate of PMVT in 12 months was compared between the treatment group and the nontreatment group.
  
  
  RESULTS
  The total incidence of PMVT after gastric surgery was 0.67 % (31/4611). Most (54.84 %) PMVT cases were detected within 1 month postoperatively. No accompanying deep vein thrombosis (DVT) was noted. Multivariate comparison with 1:4 matched control showed that combined splenectomy, synchronous malignancy, and intra-abdominal complication were independent risk factors. Advanced stage, combined splenectomy, and synchronous malignancy were independent risk factors in Poisson regression analysis using unmatched controls. The resolution rate of PMVT was not different from patients treated with anticoagulation (n = 6) or antiplatelet therapy (n = 1) and were not significantly different with those of the untreated group [85.7 % (6/7) vs. 82.3 % (14/17), p = 0.935] during 1-year follow up.
  
  
  CONCLUSIONS
  PMVT after gastric surgery was associated with advanced cancer stage, combined splenectomy, and synchronous malignancy, but it was not related to laparoscopy or DVT. Significant differences in the natural course of PMVT were not found between the treatment group and observation group.
authors.affiliation: Department of Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul, 110-744, Korea.
authors.forename: Ji-Won
authors.initials: JW
authors.lastname: Han
authors.affiliation: Department of Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul, 110-744, Korea. wisehearted@gmail.com.
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Kong
authors.affiliation: Department of Radiology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Cheong-Il
authors.initials: CI
authors.lastname: Shin
authors.affiliation: Department of Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul, 110-744, Korea.
authors.forename: Seung-Kee
authors.initials: SK
authors.lastname: Min
authors.affiliation: Department of Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul, 110-744, Korea.
authors.forename: Sang-Il
authors.initials: SI
authors.lastname: Min
authors.affiliation: Department of Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul, 110-744, Korea.
authors.forename: Tae Han
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul, 110-744, Korea.
authors.forename: Jun-Young
authors.initials: JY
authors.lastname: Yang
authors.affiliation: Department of Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul, 110-744, Korea.
authors.forename: Seung-Young
authors.initials: SY
authors.lastname: Oh
authors.affiliation: Department of Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul, 110-744, Korea.
authors.forename: Yun-Suhk
authors.initials: YS
authors.lastname: Suh
authors.affiliation: Department of Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul, 110-744, Korea.|Cancer Research Institute, Seoul National University Hospital, Seoul, Korea.
authors.forename: Hyuk-Joon
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul, 110-744, Korea.|Cancer Research Institute, Seoul National University Hospital, Seoul, Korea.
authors.forename: Han-Kwang
authors.initials: HK
authors.lastname: Yang
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D020246:Venous Thrombosis / Q000209:etiology* / Q000473:pathology
keywords: Gastrectomy; Portal vein; Splenectomy; Venous thrombosis