Abstract
BackgroundChanges in the coagulation system in patients undergoing surgery for lung cancer have been sparsely investigated and the impact of the surgical trauma on the coagulation system is largely unknown in these patients. An increased knowledge could potentially improve the thromboprophylaxis regimes. The aim of this study was to assess the coagulation profile evoked in patients undergoing curative surgery by Video-Assisted Thoracoscopic Surgery (VATS) lobectomy for primary lung cancer.MethodsThirty-one patients diagnosed with primary lung cancer undergoing VATS lobectomy were prospectively included. The coagulation profile was assessed preoperatively and in the first two days postoperatively using a wide range of standard coagulation tests, dynamic whole blood coagulation measured by rotational thromboelastometry (ROTEM®) and thrombin generation evaluated by calibrated automated thrombography. Patients did not receive thromboprophylactic treatment. Data was analyzed using repeated measures one-way ANOVA.ResultsThe standard coagulation parameters displayed only subtle changes after surgery and the ROTEM® and thrombin generation results remained largely unchanged.ConclusionsPatients undergoing VATS lobectomy are normocoagulable in the preoperative state and a VATS lobectomy does not significantly influence the coagulation.Trial registrationThe trial is registered at ClinicalTrials.gov (Identifier: NCT01741506) and at EudraCTno. 2012–002409-23. Registered December 2012.
Highlights
Changes in the coagulation system in patients undergoing surgery for lung cancer have been sparsely investigated and the impact of the surgical trauma on the coagulation system is largely unknown in these patients
The aim of this study was to assess the coagulation profile evoked in patients undergoing curative surgery by Video-Assisted Thoracoscopic Surgery (VATS) lobectomy for primary lung cancer
Three patients had been given Non Steroid Anti Inflammatory Drug (NSAID), and three patients were converted to an open procedure
Summary
Changes in the coagulation system in patients undergoing surgery for lung cancer have been sparsely investigated and the impact of the surgical trauma on the coagulation system is largely unknown in these patients. An increased knowledge could potentially improve the thromboprophylaxis regimes. Cancer patients have an increased risk of venous thromboembolic events (VTE) consisting of deep venous thrombosis (DVT) or pulmonary embolism (PE) [1]. Patients having potentially curative operations for lung. The influence on the coagulation system in patients undergoing thoracic (non-cardiac) surgery has only been sparsely investigated. Additional knowledge is warranted, since patients undergoing surgery for lung cancer still have an increased long-term risk of VTE [1,2,3]. New knowledge could potentially change the thromboprophylaxis regimen, e.g. regarding type of medication (Non-vitamin K antagonist oral anticoagulant (NOAC)
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