Postoperative prophylactic anticoagulation in the prevention of portal venous thrombosis in patients after laparoscopic splenectomy: a Meta-analysis

Abstract

Objective To study the effectiveness and safety of prophylactic anticoagulation in the prevention of portal venous thrombosis (PVST) in patients after laparoscopic splenectomy. Methods A systematic search of the PubMed, Embase, Cochrane Library, Sinomed, Wangfang, Weipu and CNKI databases was performed to identify studies which compared outcomes in patients with or without prophylactic anticoagulation after laparoscopic splenectomy. The quality of the included studies was assessed using the Cochrane collaboration tool and the Newcastle-Ottawa Scale. Heterogeneity was evaluated using the χ2 and I2 tests. The primary outcome was the incidence of postoperative PVST. Results Five studies were included into this review, which involved 206 and 168 patients with or without prophylactic anticoagulation, respectively. The incidence of PVST was significantly reduced with prophylactic anticoagulation with an odds ratio (OR) of 0.32 [95% confidence interval (CI), 0.13~0.79, P<0.05]. Conclusion Prophylactic anticoagulation resulted in a significant reduced incidence of PVST after laparoscopic splenectomy. Key words: Portal vein system thrombosis; Anticoagulants; Laparoscopic splenectomy; Meta-analysis