Danaparoid Sodium Effectively Treats Portal Vein Thrombosis after Laparoscopic Intersphincteric Resection for Rectal Cancer—A Case Report—

Abstract

Portal vein thrombosis after laparoscopic colorectal cancer surgery is rare. To date, no reliable criteria are available regarding the optimal anticoagulant and its duration of administration in such cases. We report a case of portal vein thrombosis successfully treated with danaparoid sodium in a patient who underwent laparoscopic surgery for rectal cancer. A 59-year-old man underwent laparoscopic intersphincteric resection and ileostomy for lower rectal cancer (pT1a, N0, M0, pStage 0). Laboratory tests performed on the 29^th postoperative day revealed mild liver dysfunction. Abdominal ultrasonography and contrast-enhanced computed tomography revealed portal vein thrombosis in the umbilical portion. Complete resolution of the thrombus was observed following 2-week treatment with danaparoid sodium. We had treated the patient with warfarin for 8 weeks, and no recurrence of thrombus was observed. We concluded that thrombosis was attributable to a combination of reduced blood flow through the portal vein secondary to elevated intra-abdominal pressure, carbon dioxide pneumoperitoneum, and the Trendelenburg position used during laparoscopic surgery. Danaparoid sodium effectively treats portal vein thrombosis observed after laparoscopic surgery for colorectal cancer.