Deep venous thrombosis in pediatric patients with myelomeningocele undergoing urologic reconstruction—do we need to reconsider prophylaxis?

Abstract

Objectives To review a single surgeon’s experience with the development of postoperative deep venous thrombosis after urologic reconstruction in the myelomeningocele population. This complication is rarely reported in this population, despite the multiple risk factors. We reviewed the risk factors for the development of deep venous thrombosis and present options for treatment and prevention of this potentially life-threatening complication. Methods We reviewed a single surgeon’s population of myelomeningocele patients who had undergone urologic reconstruction during a 7-year period. This series was examined retrospectively for the development of deep venous thrombosis and its evaluation and treatment. Results A total of 61 patients with myelomeningocele who had undergone urologic reconstruction during a 7-year period were identified. Of these 61 patients, deep venous thrombosis was diagnosed in 2. The risk factors common in this population were chronic immobility, recent surgery, and infection. Conclusions Deep venous thrombosis is a rarely reported complication after urologic reconstruction in the myelomeningocele population. The preoperative risk factors should be evaluated. Diligent surveillance postoperatively should be maintained. Evaluation and treatment should be prompt to decrease the risk of serious pulmonary complications.