engleski

Perioperative coagulation disorders in cancer patients, impact of thromboprophylaxis

Background: Coagulation disorders may have a significant impact on the clinical outcomes in cancer population as a consequence of tumor growth, chemotherapy, radiotherapy or due to the surgical trauma. Surgery promotes the formation of fibrin and platelet clots around tumor cell emboli, thereby impairing natural killer cell- mediated tumor cell clearance, whereas perioperative anticoagulation attenuates this effect. Undergoing surgical procedure presents an additional stress for the organism. Coagulation and anticoagulation inhibitor values analysis of perioperative measurements should have answered questions about a pathophysiological processes that are activated during the operation, but which are also blocked by applied Low molecular weight heparines, which has an antithrombin' profibrinolytic and antiaggregational effect. Changes in coagulation and fibrinolysis inhibitor activity can perioperatively cause trombosis and/or bleeding. Awareness of underlying mechanisms should point to preventive strategies, early diagnostics, and appropriate treatment of cancer and coagulation disorders associated. By activating t-PA and blocking PAI-1, thromboprophylaxis with LMW Heparin creates a stable and balanced perioperative system of haemostasis. Those may have a significant impact on the clinical outcomes in this suspectible population. Conclusion: The site of injury, as well as in haemophilia, thrombocytopenia, functional deficits of thrombocites and major bleeding due to trauma and surgery in cancer patients increases thrombin generation. The resulting clot is resistant to locally activated fibrinolysis. By activating t-PA and blocking PAI- I, thromboprophylaxis with Low molecular weight heparines (LMWH) creates a stable and balanced perioperative system of haemostasis.

cancer ; coagulation disorders ; surgery ; thrornboprophylaxis

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