[Blood coagulation-fibrinolysis system during transurethral resection evaluated by thrombelastography].
Intraoperative changes in blood coagulation-fibrinolysis system were evaluated in 21 patients under epidural anesthesia by thrombelastography. Ten patients received transurethral resection of prostate (TUR-P) and 11 patients received transurethral resection of bladder tumor (TUR-Bt). Thrombelastographic variables: reaction time (R), coagulation time (K), maximum amplitude (MA), and amplitude 60 min after MA (A 60) were measured. The coagulability was evaluated by R + K, the absolute strength of clot by MA, and fibrinolysis using MA-A60. There was no significant change of these indices in TUR-Bt group. On the other hand, in TUR-P group, R + K was significantly shortened and MA-A60 had a tendency to increase it, but MA caused no change. Resected prostatic weight correlated significantly with the decrease of MA, and had a tendency to correlate with the increase of MA-A60 in TUR-P group. Both coagulation and fibrinolysis were activated in TUR-P group. When the resected prostatic weight is large, the risk of coagulopathy may increase.
Tomiyama
Y
Y
Department of Anesthesiology, Tokushima University School of Medicine, Japan.
Kimura
H
H
Kitahata
H
H
Yamashita
M
M
Kohyama
A
A
D000767:Anesthesia, Epidural; D001777:Blood Coagulation; D005260:Female; D005342:Fibrinolysis; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D009929:Organ Size; D011467:Prostate / Q000473:pathology; D011468:Prostatectomy; D013916:Thrombelastography; D001749:Urinary Bladder Neoplasms / Q000601:surgery