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Session:: ePosters-Sat-M3: Inflammatory Bowel Disease

EP137 - Venous Thromboembolism after Colectomy vs. Completion Proctectomy in Ulcerative Colitis: Does In-situ Diseased Colon Increase Risk?

Saturday, May 9, 2026
3:58 PM - 4:03 PM ET

    ePoster Presenter(s)

  • Miriannie Rivera Valerio, MD, MS (she/her/hers)

    Resident Physician
    Howard University Hospital
    Howard University Hospital
    Washington, DC, United States

    All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

    View ePoster

    • Author(s)

  • AZ

    Ahmad Zeineddin, MD

    Resident Physician
    Howard University Hospital
    WASHINGTON, District of Columbia, United States

    Disclosure information not submitted.

  • SN

    Siobhan Nnorom, MD

    Research Fellow
    Howard University
    Hanover, Maryland, United States

    Disclosure information not submitted.

  • MT

    May Tee, MD, MPH, FACS

    Associate Professor of Surgical Oncology
    Howard University
    Washington, District of Columbia, United States

    Disclosure information not submitted.

  • Debra H. Ford, MD, FACS, FASCRS, MAMSE (she/her/hers)

    Senior Associate Dean for Academic Affairs; Associate Professor of Surgery
    Howard University College of Medicine (HUCM)
    Howard University College of Medicine
    Mitchellville, MD, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • CN

    Christine Nembhard, MD, FACS, FASCRS

    Assistant Professor
    Howard University Hospital
    Washington, District of Columbia, United States

    Disclosure information not submitted.

Purpose/Background: Patients with Ulcerative Colitis (UC) have a two to three-fold increased risk of venous thromboembolism (VTE) compared with the general population. This is driven by chronic systemic inflammation and perioperative factors. Surgical treatment further augments this risk, yet the impact of surgical and disease extent on VTE remains unclear. This study examines the risk of postoperative VTE after resection of diseased colon versus completion proctectomy when the diseased colon has previously been removed.

Methods/Interventions: The National Inpatient Sample (2005-2019) was queried for adults with UC undergoing colorectal resection. Patients were grouped into total abdominal colectomy (TAC), total proctocolectomy (TPC) and completion proctectomy (Proc). Demographics and comorbidities were described. The primary outcome was postoperative VTE; secondary outcomes included anastomotic leak, bleeding, length of stay (LOS), and mortality. Multivariate logistic regression identified independent risk factors for VTE.

Results/Outcomes: A total of 12,613 patients were identified (mean age 49 ± 18 years, 55% male): TAC 55%, TPC 20% and Proc 25%. Proc patients were younger (45 ± 17 vs 50 ± 19 years for TAC and 49 ± 17 years for TPC, p < 0.01), with no gender difference. TAC patients were least likely to have private insurance (58% vs 71% TPC vs 74% Proc, p < 0.01). Elective procedures were most common in Proc (89% vs 50% TAC vs 84% TPC, p < 0.01). VTE occurred in 1.4% of Proc, 5.7% of TAC, and 2.7% of TPC patients (p < 0.01). Anastomotic leak rates were 0.57% after Proc, 1.4% TAC, and 0.82% TPC, (p < 0.01), with no significant difference in bleeding (3.8% vs 3.6% vs 4.7%, p = 0.08). Median LOS was shortest for Proc (6 [4-9] days) compared with TAC (9 [5-17] days) and TPC (7 [5-11] days, p < 0.01). Mortality was 0.42% for Proc, 6.3% for TAC, and 0.84% for TPC (p < 0.01).

On multivariate analysis adjusting for age, sex, and comorbidities, when compared to Proc, TAC (OR 1.72, 95% CI 1.20-2.45) and TPC (OR 1.49, 95% CI 1.01-2.22) showed higher odds of VTE. Diversion (OR 1.48, 95% CI 1.13-1.93) and non-elective surgery (OR 4.54, 95% CI 3.64-5.67) were also independently associated with increased VTE risk.

Conclusion/Discussion: Completion proctectomy in patients with Ulcerative Colitis was associated with the lowest incidence of VTE. After risk adjustment, colectomy (TAC and TPC), particularly when performed emergently or with diversion, remained independently associated with higher VTE odds. These findings suggest that both extent of ongoing disease activity, extent of resection and operative urgency contribute to persistent thrombo-inflammatory risk, underscoring the need for vigilant perioperative prophylaxis and targeted post-discharge prevention in high-risk UC patients.