Our Summary

The study looks at the risk of blood clots (venous thromboembolism or VTE) after surgery to remove part of the colon (a colectomy) due to diverticular disease. This disease affects the large intestine and can cause severe abdominal pain. The data used for this study comes from English medical records between 2000 and 2019.

The study found that of the roughly 24,000 patients who had this surgery for diverticular disease, over half were emergency procedures. The highest risk of blood clots was seen in patients aged 70 or above within 30 days after surgery. Also, patients who had emergency surgeries had twice the risk of developing a blood clot compared to those who had planned surgeries.

Interestingly, a less invasive type of surgery (minimally invasive surgery or MIS) was associated with a 64% reduction in blood clot risk compared to more traditional, open surgeries at 30 days after surgery.

The risk of blood clots remained higher for emergency surgeries compared to planned surgeries even 90 days after the operation.

The takeaway from this study is that there is a higher risk of blood clots after emergency colectomy for diverticular disease, especially for older patients. But less invasive surgeries can lower this risk. This suggests that efforts to prevent blood clots after surgery for diverticular disease should focus on patients having emergency surgeries.

FAQs

  1. What group of patients is at the highest risk of developing blood clots after a colectomy for diverticular disease?
  2. What type of surgery is associated with a lower risk of blood clots after a colectomy for diverticular disease?
  3. Does the risk of blood clots continue to remain higher for emergency surgeries compared to planned surgeries even after 90 days post-operation?

Doctor’s Tip

A helpful tip a doctor might tell a patient about colectomy is to stay active and mobile as soon as possible after surgery to help prevent blood clots. This can include walking around the hospital ward or doing gentle exercises as recommended by your healthcare team. Additionally, wearing compression stockings or using compression devices on your legs may also help reduce the risk of blood clots. Be sure to follow your doctor’s instructions and attend any follow-up appointments to monitor for any signs of complications.

Suitable For

Typically, patients who are recommended for colectomy are those with severe diverticular disease that causes significant symptoms such as chronic abdominal pain, bleeding, perforation, or obstruction. Emergency colectomy may be necessary in cases of acute complications such as severe infection or bowel perforation. Older patients, especially those aged 70 or above, may be at higher risk for complications such as blood clots after surgery and may require special attention and preventive measures. Minimally invasive surgery may be preferred over traditional open surgery to reduce the risk of postoperative complications, including blood clots.

Timeline

Overall, the timeline of a patient’s experience before and after colectomy for diverticular disease may look something like this:

Before Surgery:

  • Patient experiences severe abdominal pain due to diverticular disease
  • Surgery is recommended by healthcare providers
  • Pre-operative assessments and consultations are conducted
  • Surgery is scheduled, either as an emergency or planned procedure

After Surgery:

  • Immediate post-operative recovery in the hospital
  • Potential complications such as blood clots may arise, especially in older patients or those who had emergency surgeries
  • Follow-up appointments and monitoring for any post-operative issues
  • Patients who had minimally invasive surgery may have a lower risk of blood clots compared to those who had open surgery
  • Continued monitoring for blood clots up to 90 days post-surgery, especially for patients who had emergency procedures

In conclusion, the experience of a patient before and after colectomy for diverticular disease involves careful consideration of the surgical approach, risk factors for complications such as blood clots, and ongoing monitoring for any post-operative issues.

What to Ask Your Doctor

  1. What are the risks and benefits of having a colectomy surgery for diverticular disease?
  2. What are the potential complications of the surgery, including the risk of blood clots?
  3. Are there any specific factors that may increase my risk of developing blood clots after the surgery?
  4. How will blood clot prevention measures be incorporated into my treatment plan before, during, and after the surgery?
  5. What is the difference in risk between having a planned colectomy versus an emergency colectomy for diverticular disease?
  6. What type of surgical approach (minimally invasive vs. traditional open surgery) do you recommend for my case, and how does this impact the risk of blood clots?
  7. How long will I need to take blood clot prevention medications after the surgery?
  8. What symptoms should I watch out for that may indicate a blood clot post-surgery?
  9. How often will I need to follow up with you after the surgery to monitor for any potential complications, including blood clots?
  10. Are there any lifestyle changes or precautions I should take to reduce my risk of developing blood clots after the surgery?

Reference

Authors: Yapa AKDS, Humes DJ, Crooks CJ, Lewis-Lloyd CA. Journal: Langenbecks Arch Surg. 2023 May 22;408(1):203. doi: 10.1007/s00423-023-02920-6. PMID: 37212868