Risk factors of portal vein thrombosis in patients with beta thalassemia major after splenectomy: laparoscopic versus open procedure.

BACKGROUND/AIMS: Beta thalassemia major patients are at a high risk of thromboembolic events due to a hypercoagulable state, and nowadays laparoscopic splenectomy (LS) has become the standard surgical procedure for many benign diseases. The aim of this study is to show our experience of LS for beta thalassemia major, and to explore predictive factors for portal vein thrombosis (PVT) after splenectomy.

METHODOLOGY

We performed a retrospective chart review of 25 cases of LS (Group 1) and 34 cases of open splenectomy (OS, Group 2) in beta thalassemia major patients. Patients' perioperative, intraoperative and postoperative information was recorded and compared.

RESULTS

Compared with Group 2, patients in Group 1 had significantly increasing operative time, less estimated blood loss (EBL), decreasing postoperative stays, and shorter duration of oral intake. Related variables were assessed by univariate and multivariate logistic regression analyses, indicating splenic weight (cutoff value: 1311.5 g) was a significant independent predictor for PVT after LS. Regardless of LS or OS, some patients responded to splenectomy completely, while some responded partially.

CONCLUSIONS

According to this study, LS is associated with better surgical outcomes for beta thalassemia major compared with OS. Patients receiving LS may be susceptible to PVT, and splenic weight can be used as a predictor.