Thromboembolic and hemorrhagic complications in cancer surgery

Abstract

Postoperative thromboembolic and hemorrhagic complications (TEC and HC) were analyzed in 300 cancer surgical patients of a different profile in the same period of time, by assessing multiple risk factors and their prognostic value. There was a preponderance of postoperative HC (5%) over TEC (3%); the patients who received anticoagulant prevention (ACP) developed HC by twice more frequently than those who did not. In different periods after surgery the patients, including ACP-receiving ones, developed TEC: deep vein thrombosis of the lower extremity on days 7-20 mainly after operations on abdominal and small pelvic organs, pulmonary artery thromboembolism on days 1-7 after thoracoabdominal operations. HO was prevalent in patients who had undergone removal of tumors of the head and neck in the complete absence of TEC. All complications were abolished without any fatal outcomes. The authors show it necessary to apply a differential approach to using ACP before extensive cancer operations (including those in patients at risk for thrombus), by taking into account the risk for high intraoperative blood loss and postoperative hemorrhage in the presence of large wound surfaces and posthemorrhagic and drug-induced hypocoagulation. It is expedient to develop an algorithm for the management of cancer surgical patients of a different profile, which provides the prevention of not only TEC, but also HC.