IMPACT OF POSTOPERATIVE COMPLICATIONS ON PORTAL THROMBOSIS IN SPLENECTOMY PATIENTS

Veysel Umman; Hafize Basut Atalay; Recep Temel; Turan Alisoy; Kaan Balcı; Sedat Fırat Okutan; Taylan Özgür Sezer; Özgür Fırat; Sinan Ersin

Makale detayları

IMPACT OF POSTOPERATIVE COMPLICATIONS ON PORTAL THROMBOSIS IN SPLENECTOMY PATIENTS

Yazarlar:

Veysel Umman | Hafize Basut Atalay | Recep Temel | Turan Alisoy | Kaan Balcı | Sedat Fırat Okutan | Taylan Özgür Sezer | Özgür Fırat | Sinan Ersin

Yayıncı:

Istanbul University

Ana Başlıklar:

Sağlık Hizmetleri ve Sistemleri (Diğer)

Dergi:

İstanbul Tıp Fakültesi Dergisi Vol.86 Issue 4, pp.354-359

Belge Tipi:

Makale

Yayın Tarihi:

1/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001310896

pISSN:

1305-6441

Anahtar kelimeler:

Özet:

 Objective: Venous thromboembolism is one of the significant complications after elective and emergency splenectomy. Up to 35 of portal and splenic venous thromboembolism has been reported in the first two months after splenectomy for hematologic malignancy. Our objectives were to compare emergency and elective splenectomy and their complications, and to analyze the risks on the development of portal vein thrombosis PVT. Material and Method: A total of 78 splenectomy cases performed between 2017-2023 and that had complete medical records were included in this study. Of these cases, 39 were emergency and 39 were elective procedures. The two groups were compared retrospectively for risks of PVT. Result: We found a significant relationship between the development of postoperative complications and the risk of PVT p0.004. The risk of developing PVT in emergency cases in the post-operative 2 weeks was significantly higher than elective cases p0.048. Shorter operation times, larger spleen sizes, lower platelet counts and malignancy in pathology results were found to be significantly in favor of elective cases p0.007, p0.004, p0.001, p0.001, respectively. In emergency cases, the need for RBC transfusion and complications were more frequent p0.001, p0.021. Conclusion: High-risk patients should be evaluated for prophylacticanticoagulation with low-molecular-weight heparin in the postoperative period and after discharge. Anticoagulation should be considered for emergency splenectomy, factoring in cost-benefit, and a low suspicion for venous thromboembolism should be maintained with timely investigation. In this sense, our study supports the existing data with its current results.

 Objective: Venous thromboembolism is one of the significant complications after elective and emergency splenectomy. Up to 35 of portal and splenic venous thromboembolism has been reported in the first two months after splenectomy for hematologic malignancy. Our objectives were to compare emergency and elective splenectomy and their complications, and to analyze the risks on the development of portal vein thrombosis PVT. Material and Method: A total of 78 splenectomy cases performed between 2017-2023 and that had complete medical records were included in this study. Of these cases, 39 were emergency and 39 were elective procedures. The two groups were compared retrospectively for risks of PVT. Result: We found a significant relationship between the development of postoperative complications and the risk of PVT p0.004. The risk of developing PVT in emergency cases in the post-operative 2 weeks was significantly higher than elective cases p0.048. Shorter operation times, larger spleen sizes, lower platelet counts and malignancy in pathology results were found to be significantly in favor of elective cases p0.007, p0.004, p0.001, p0.001, respectively. In emergency cases, the need for RBC transfusion and complications were more frequent p0.001, p0.021. Conclusion: High-risk patients should be evaluated for prophylacticanticoagulation with low-molecular-weight heparin in the postoperative period and after discharge. Anticoagulation should be considered for emergency splenectomy, factoring in cost-benefit, and a low suspicion for venous thromboembolism should be maintained with timely investigation. In this sense, our study supports the existing data with its current results.

 Objective: Venous thromboembolism is one of the significant complications after elective and emergency splenectomy. Up to 35 of portal and splenic venous thromboembolism has been reported in the first two months after splenectomy for hematologic malignancy. Our objectives were to compare emergency and elective splenectomy and their complications, and to analyze the risks on the development of portal vein thrombosis PVT. Material and Method: A total of 78 splenectomy cases performed between 2017-2023 and that had complete medical records were included in this study. Of these cases, 39 were emergency and 39 were elective procedures. The two groups were compared retrospectively for risks of PVT. Result: We found a significant relationship between the development of postoperative complications and the risk of PVT p0.004. The risk of developing PVT in emergency cases in the post-operative 2 weeks was significantly higher than elective cases p0.048. Shorter operation times, larger spleen sizes, lower platelet counts and malignancy in pathology results were found to be significantly in favor of elective cases p0.007, p0.004, p0.001, p0.001, respectively. In emergency cases, the need for RBC transfusion and complications were more frequent p0.001, p0.021. Conclusion: High-risk patients should be evaluated for prophylacticanticoagulation with low-molecular-weight heparin in the postoperative period and after discharge. Anticoagulation should be considered for emergency splenectomy, factoring in cost-benefit, and a low suspicion for venous thromboembolism should be maintained with timely investigation. In this sense, our study supports the existing data with its current results.

 Amaç: Terapötik ve acil splenektomi sonrası gelişen önemli komplikasyonlardan biri venöz tromboembolidir. Hematolojik malignite nedeniyle splenektomi sonrası ilk iki ay içerisinde 35e varan portal ve splenik venöz tromboembolizm bildirilmiştir. Bu çalışmada, acil ve elektif splenektomi operasyonlarını ve komplikasyonlarını karşılaştırarak portal ven trombozu PVT gelişimi üzerindeki risklerin incelenmesi amaçlandı. Gereç ve Yöntem: Çalışmaya 2017-2023 yılları arasında gerçekleştirilen ve kayıtları eksiksiz olan 78 splenektomi vakası dahil edildi. Bu vakalardan 39u acil, 39u ise elektif prosedürlerdi. İki grup portal tromboembolizm ve riskleri açısından retrospektif olarak karşılaştırıldı. Bulgular: Ameliyat sonrası komplikasyon görülmesi ile PVT gelişimi riski arasında anlamlı bir ilişki saptanmıştır p0,004. Operasyon tipi olarak inclediğimizdeyse ameliyat sonrası ilk iki haftalık süreçteki acil vakalarda PVT gelişimi riski, elektif vakalara göre anlamlı ölçüde yüksek bulunmuştur p0,048. Ayrıca, kısa ameliyat süresi, büyük dalak boyutu, düşük trombosit sayısı ve patoloji sonuçlarında malignite olması elektif vakalar lehine anlamlı bulunmuştur sırasıyla p0,007, p0,004, p0,001, p0,001, p0,001. Acil vakalardaysa kan replasmanı ihtiyacı ve komplikasyonlar daha sık görülmüştür sırasıyla p0,001, p0,021. Sonuç: Yüksek riskli hastalar ameliyat sonrasındaki dönemde ve taburculuk sonrasında düşük molekül ağırlıklı heparin ile profilaktik antikoagülasyon açısından değerlendirilmelidir. Acil splenektomi vakalarında karzarar oranı göz önünde bulundurularak antikoagülasyon düşünülmeli ve olası venöz tromboemboli için şüphe eşiği düşük tutulup erken tetkik edilmelidir. Bu anlamda çalışmamız güncel sonuçları ile mevcut verileri desteklemektedir.

Makale detayları

IMPACT OF POSTOPERATIVE COMPLICATIONS ON PORTAL THROMBOSIS IN SPLENECTOMY PATIENTS

Yazarlar:

Veysel Umman | Hafize Basut Atalay | Recep Temel | Turan Alisoy | Kaan Balcı | Sedat Fırat Okutan | Taylan Özgür Sezer | Özgür Fırat | Sinan Ersin

Yayıncı:

Istanbul University

Ana Başlıklar:

Sağlık Hizmetleri ve Sistemleri (Diğer)

Dergi:

İstanbul Tıp Fakültesi Dergisi Vol.86 Issue 4, pp.354-359

Belge Tipi:

Makale

Yayın Tarihi:

1/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001310896

pISSN:

1305-6441

Splenectomy

portal thrombosis

emergency surgery

splenomegalySplenektomi

portal tromboz

acil cerrahi

splenomegali

Sayı

Makale detayları

Yazarlar: Veysel Umman | Hafize Basut Atalay | Recep Temel | Turan Alisoy | Kaan Balcı | Sedat Fırat Okutan | Taylan Özgür Sezer | Özgür Fırat | Sinan Ersin

Yayıncı: Istanbul University

Ana Başlıklar: Sağlık Hizmetleri ve Sistemleri (Diğer)

Dergi: İstanbul Tıp Fakültesi Dergisi Vol.86 Issue 4, pp.354-359

Belge Tipi: Makale

Yayın Tarihi: 1/2023

Belge Dili: İngilizce

Document ID (Org No.): 2001310896

pISSN: 1305-6441

Sayı

Yazarlar:

Veysel Umman | Hafize Basut Atalay | Recep Temel | Turan Alisoy | Kaan Balcı | Sedat Fırat Okutan | Taylan Özgür Sezer | Özgür Fırat | Sinan Ersin

Yayıncı:

Istanbul University

Ana Başlıklar:

Sağlık Hizmetleri ve Sistemleri (Diğer)

Dergi:

İstanbul Tıp Fakültesi Dergisi Vol.86 Issue 4, pp.354-359

Belge Tipi:

Makale

Yayın Tarihi:

1/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001310896

pISSN:

1305-6441