Portomesenteric venous thrombosis following major colon and rectal surgery: incidence and risk factors

Abstract

BMI ≥ 30 kg/m(2), thrombocytosis, and restorative proctocolectomy were significant predictors of PMVT. Initial diagnostic studies showed a PMVT rate of 1.4%; however, after expert focused radiologic review, the actual rate was 3%. Thus, the diagnosis of PMVT is difficult and readmission after colorectal surgery should prompt its consideration.

Systematic review: outcomes and post‐operative complications following colectomy for ulcerative colitis

“…The rates of any complication, small bowel obstruction and pouch loss/pouch failure/pouch excision reported across the 17 USA studies were higher compared with those reported across the 11 non‐USA studies (46.8%, 17.2% and 13.3% vs. 16.7%, 14.9% and 2.2% respectively). The rates of ileus, pouchitis, faecal incontinence and fistula could not be compared as they were reported in the USA studies only; similarly mortality was reported in the non‐USA studies only.…”

“…Hand‐searches of conference proceedings and of reference lists yielded six additional studies. The SR update yielded three further studies . In total, 28 studies were included: 27 non‐RCTs and one RCT.…”

“…The study characteristics of the 28 studies included in this review, reporting data for patients who received surgical colorectal procedures from 2002 to 2015, are presented in Table S5. In total, 20 081 patients with UC were enrolled across the 28 studies; the age of patients undergoing surgery ranged from 7 to 97 years . A variety of surgical procedures was performed by laparoscopic or open approach in one‐, two‐ or three stages, and included ileal pouch‐anal anastomosis, Hartmann's procedure, ileorectal anastomosis, restorative proctocolectomy and total proctocolectomy.…”

“…More than half of the 28 studies included were conducted in the USA ( n = 17) with the remaining studies being conducted worldwide, including Japan ( n = 4) and Denmark ( n = 2) …”

Eisenmangel, Thrombozytose und Thromboembolie

“…Während die primäre Thrombozytose ein unumstrittener prothrombogener Risikofaktor darstellt, gilt die sekundäre Thrombozytose generell als harmlos [13]. Obwohl große prospektive Studien größtenteils fehlen, konnte in mehreren Analysen gezeigt werden, dass eine Thrombozytose in unterschiedlichen Situationen wie postoperativ [43,44], posttraumatisch [45], bei Intensivpatienten [46,47], SIRS (systemic inflammatory response syndrome) [48] [66,67]. Die Ausprägung der CED-assoziierten Thrombozytose korreliert mit der entzünd-lichen Aktivität [68,69] und ist einerseits durch die Wirkung proinflammatorischer Zytokine wie Interleukin 6 bedingt [70], andererseits scheint Eisenmangel ebenfalls eine Rolle zu spielen [21,69,71].…”