{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T21:47:28Z","timestamp":1766267248652},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,4,2]],"date-time":"2016-04-02T00:00:00Z","timestamp":1459555200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Data on risk factors for portomesenteric venous thrombosis (<jats:styled-content style=\"fixed-case\">PMVT<\/jats:styled-content>) following abdominal surgery for ulcerative colitis (<jats:styled-content style=\"fixed-case\">UC<\/jats:styled-content>) are limited. The aim of this study was to investigate factors associated with <jats:styled-content style=\"fixed-case\">PMVT<\/jats:styled-content> after surgical treatment for <jats:styled-content style=\"fixed-case\">UC<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Patients who underwent restorative proctocolectomy (<jats:styled-content style=\"fixed-case\">RPC<\/jats:styled-content>) and ileal pouch\u2010anal anastomosis (<jats:styled-content style=\"fixed-case\">IPAA<\/jats:styled-content>) including diverting ileostomy closure for medically refractory <jats:styled-content style=\"fixed-case\">UC<\/jats:styled-content> were identified from a prospectively maintained database. Patient\u2010related, disease\u2010related and treatment\u2010related variables were collected. Univariable and multivariable analyses were performed to assess factors associated with <jats:styled-content style=\"fixed-case\">PMVT<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 521 patients completing surgical treatment for <jats:styled-content style=\"fixed-case\">UC<\/jats:styled-content> between 2006 and 2012, symptomatic <jats:styled-content style=\"fixed-case\">PMVT<\/jats:styled-content> occurred in 36 (7%), which resulted in a significantly increased hospital stay (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001). Patients developing <jats:styled-content style=\"fixed-case\">PMVT<\/jats:styled-content> were younger (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.014), had a lower preoperative albumin level (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.037) and were more likely to have been taking steroids within 1\u00a0month before surgery (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.006). The combined incidence of <jats:styled-content style=\"fixed-case\">PMVT<\/jats:styled-content> was comparable between patients having a three\u2010stage and two\u2010stage management (6% <jats:italic>vs<\/jats:italic> 8%, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.43), but the relative incidence of <jats:styled-content style=\"fixed-case\">PMVT<\/jats:styled-content> after <jats:styled-content style=\"fixed-case\">RPC<\/jats:styled-content>\u00a0+\u00a0<jats:styled-content style=\"fixed-case\">IPAA<\/jats:styled-content> was 8%, significantly higher than the 4% after total abdominal colectomy (TAC) (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.005) and the 2% after subsequent completion proctectomy (CP)\u00a0+\u00a0<jats:styled-content style=\"fixed-case\">IPAA<\/jats:styled-content> (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.038). Multivariate analysis confirmed that <jats:styled-content style=\"fixed-case\">RPC<\/jats:styled-content>\u00a0+\u00a0<jats:styled-content style=\"fixed-case\">IPAA<\/jats:styled-content> was associated with a significantly greater risk of <jats:styled-content style=\"fixed-case\">PMVT<\/jats:styled-content> than CP\u00a0+\u00a0<jats:styled-content style=\"fixed-case\">IPAA<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a04.9, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.003) or TAC (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a03.5, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.011). Preoperative steroid use was an independent factor for <jats:styled-content style=\"fixed-case\">PMVT<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a05.8, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.006).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Steroid use 1\u00a0month before surgery is associated with an increased risk of <jats:styled-content style=\"fixed-case\">PMVT<\/jats:styled-content>. A staged restorative proctocolectomy does not increase the overall incidence of <jats:styled-content style=\"fixed-case\">PMVT<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.13275","type":"journal-article","created":{"date-parts":[[2016,1,16]],"date-time":"2016-01-16T18:14:40Z","timestamp":1452968080000},"page":"393-399","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Risk factors associated with portomesenteric venous thrombosis in patients undergoing restorative proctocolectomy for medically refractory ulcerative colitis"],"prefix":"10.1111","volume":"18","author":[{"given":"J.","family":"Gu","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease Institute Cleveland Clinic Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Stocchi","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease Institute Cleveland Clinic Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Gorgun","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease Institute Cleveland Clinic Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. 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