[Mechanism of development of fatal pulmonary artery thromboembolism during the treatment of kidney and bladder cancer].
Retrospective evaluation of the state of hemostasis in 20 patients dying with pulmonary artery thromboembolism (PATE) after combined treatment of renal carcinoma (10) and urinary bladder carcinoma (10) was performed. The signs of intravascular blood coagulation (IVBC) in the initial condition were determined in all the patients. After a course of pre-operation actin therapy with large fractions (totally 20 g) activation of IVBC was observed both in renal and urinary bladder carcinoma. In the postoperation period, on the day of PATE development in patients with renal carcinoma the state of hemostasis corresponded to stage I of disseminated intravascular coagulation syndrome. In patients with urinary bladder carcinoma after operation the state of hemostasis corresponded to stage II of DIVC-syndrome with signs of local hemorrhage of the urinary bladder wound. The therapy of this condition with fibrinolysis inhibitors (aminocaproic acid) with hemotransfusion without heparin facilitated thrombus formation in these patients in deep pelvic veins followed by PATE.
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000209:etiology* / Q000401:mortality; D001749:Urinary Bladder Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*
K mekhanizmu razvitiia tromboémboliĭ legochnoĭ arterii s letal'nym iskhodom pri lechenii bol'nykh rakom pochek i mochevogo puzyria.