ASCRS Annual Scientific Meeting

Low Venous Thromboembolism Risk Following Colorectal Surgery for Pelvic Floor and Motility Disorders

Anthony Calabro, MA

Key Highlights

  • The 90-day venous thromboembolism (VTE) rate following colorectal surgery for pelvic floor and motility disorders was 1.6%.
  • Most VTEs occurred more than 30 days postoperatively.
  • Portomesenteric venous thromboses accounted for the largest proportion of VTE events.
  • Subtotal colectomy for slow transit constipation was associated with the highest VTE risk.

In a large single-institution study, the overall 90-day incidence of VTE following colorectal surgery for pelvic floor and motility disorders was found to be low, at 1.6%. Patients undergoing subtotal colectomy for slow transit constipation had the highest VTE rates compared with other procedures. The study authors presented their results at the American Society of Colon & Rectal Surgeons Annual Scientific Meeting in San Diego, CA.

While VTE risk is well-characterized for many types of surgeries, data regarding patients undergoing colorectal procedures for pelvic floor and motility disorders is sparse. Given the serious consequences of VTE, this study set out to better understand incidence and risk factors in this specific patient population.

Researchers conducted a retrospective review of adult patients who underwent rectal prolapse repair, subtotal colectomy with ileorectal or end ileostomy formation, or sacral nerve modulation for fecal incontinence between January 1, 2006, and December 31, 2023. VTEs, defined as extremity deep venous thromboses, portomesenteric venous thromboses, or pulmonary emboli, were identified through diagnosis codes within the electronic medical record over a 90-day postoperative period.

Among 818 patients, 73.1% underwent rectal prolapse repair, 16.9% underwent subtotal colectomy, and 10% underwent sacral nerve modulation. The overall 90-day VTE incidence was 1.6%. The majority of VTEs (61.5%) were diagnosed more than 30 days after surgery. Portomesenteric venous thromboses were the most common type of VTE, accounting for 38.5% of all thrombotic events. The highest VTE incidence was seen following subtotal colectomy (7.2%), whereas prolapse procedures carried a VTE risk of 0.5%. No VTE events occurred following sacral nerve modulation.

"Overall, the VTE event rate following colorectal surgery for pelvic floor and motility disorders is low. Special consideration might be given to patients undergoing subtotal colectomy for slow transit constipation," the authors concluded.

Reference
Tomlinson JL, Mirande MD, McKenna NP, Perry WR. Venous thromboembolism risk in colorectal surgery for pelvic floor and motility disorders. Presented at: 2025 American Society of Colon and Rectal Surgeons Annual Meeting; 2025; San Diego, CA. Available at: https://ascrs25.eventscribe.net/agenda.asp?pfp=ePosters. Accessed April 25, 2025.