选择性脾切除术是多种血液系统疾病的主要治疗方法。门脾肠系膜静脉血栓形成是该手术最严重的并发症之一。本研究的目的是评估择期脾切除术后门脾肠系膜静脉血栓形成的相关危险因素。这项单中心回顾性队列研究纳入了2017年4月1日至2023年1月31日期间进行的所有择期脾切除病例。对患者的人口统计数据和围手术期数据进行分析，并将其与术后血栓形成的发生率相关联。所有患者均接受术后多普勒超声筛查血栓形成。使用SPSS 28进行分析，p值<0.05被认为是显着的。22名患者（10名女性，12名男性）在研究期间接受了脾切除术。适应症为：免疫性血小板减少症（n：6）、骨髓增殖性疾病（n：6）、遗传性球形红细胞增多症（n：4）、地中海贫血（n：1）、淋巴瘤（n：1）、白血病（n：1）、其他恶性肿瘤（n：3）。 6 名患者出现门脾肠系膜静脉血栓，其中仅 2 名有症状。患者接受抗凝治疗后病情完全缓解。分析确定了与血栓形成相关的三个主要因素：脾脏直径（p = 0.03）、骨髓增殖性疾病（p = 0.02）、术中血小板输注（p = 0.002）和术中红细胞输注（p = 0.009）。标准化的术后筛查可以及时发现即使是无症状病例，也能诊断和治疗门脾肠系膜静脉血栓。脾肿大并受骨髓增殖性疾病影响的患者发生这种并发症的风险更大。版权所有 © 2023 Baldari、Boni、Giuliani 和 Cassinotti。

Elective splenectomy is the main treatment for a wide range of haematological diseases. Porto-spleno-mesenteric venous thrombosis represents one of the most severe complications of this procedure. The aim of this study was to evaluate risk factors associated with development of porto-spleno-mesenteric venous thrombosis after elective splenectomy.All cases of elective splenectomy carried out from April 1st 2017 to January 31st 2023 were included in this single centre retrospective cohort study. Patients' demographics and perioperative data were analysed and correlated with the incidence of postoperative thrombosis. All patients underwent postoperative doppler ultrasound screening for thrombosis. Analysis was performed using SPSS 28, with p-value < 0.05 considered significant.Twenty-two patients (10 women, 12 men) underwent splenectomy during the study period. Indications were: immune thrombocytopenia (n: 6), myeloproliferative disorder (n: 6), hereditary spherocytosis (n: 4), thalassemia (n: 1), lymphoma (n: 1), leukaemia (n: 1), other malignancies (n: 3). Six patients developed porto-spleno-mesenteric venous thrombosis and only 2 of them were symptomatic. Patients were treated with anticoagulation therapy with complete resolution. Analysis identified three main factors associated with thrombosis: spleen diameter (p = 0.03), myeloproliferative disorder (p = 0.02), intraoperative platelet transfusion (p = 0.002) and intraoperative red blood cells transfusion (p = 0.009).Standardized postoperative screening allows prompt diagnosis and treatment of porto-spleno-mesenteric venous thrombosis even in asymptomatic cases. Patient with splenomegaly and affected by myeloproliferative disorder have a greater risk to develop this complication.Copyright © 2023 Baldari, Boni, Giuliani and Cassinotti.