Evaluation of markers of deep vein thrombosis in patients undergoing surgery for maxillofacial malignancies.
During and following significant surgical intervention, deep venous thrombosis prophylaxis by application of anticoagulants is routinely used. However, patients with malignant disorders are subject to an especially high risk of deep venous thrombosis progressing in severe cases to subsequent pulmonary embolism. The present study focuses on appraising modern markers of deep vein thrombosis in 34 patients undergoing major maxillofacial surgery, with some malignant disorders. No significant differences between the two patient groups were noted using the markers of the kallikrein-kinin-system. From the first postoperative day plasma levels of the coagulation indicator thrombin-antithrombin-III complexes were significantly higher in the group of tumour patients. Markers of fibrinolysis indicated corresponding results: on the first postoperative day tissue-plasminogen activator values rose to 18.9 +/- 3.2 micrograms/l in the group of malignant patients, but only to 7.4 +/- 1.1 micrograms/l (P < 0.05) in the control group. Also postoperative D-dimer concentrations in the malignancy group were significantly above those of the control group. In the present study it could be demonstrated that patients with malignant neoplasia undergoing major maxillofacial surgery are exposed postoperatively to a particularly high risk of developing thromboembolic complications. All in all, the status of anti-thrombotic therapy requires reappraisal with respect to the current treatment approach adopted in tumour patients.
Wendel
H P
HP
Department of Thoracic, Cardiac and Vascular Surgery, Eberhard-Karls-University, Tuebingen, Germany. hp.wendel@uni-tuebingen.de
Scholpp
J
J
Schulze
H J
HJ
Heller
W
W
Schwenzer
N
N
D000990:Antithrombin III / Q000032:analysis; D001780:Blood Coagulation Tests; D016022:Case-Control Studies; D015956:Factor XIIa / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis; D006258:Head and Neck Neoplasms / Q000097:blood / Q000601:surgery*; D006801:Humans; D016234:Kallikrein-Kinin System; D016343:Monitoring, Intraoperative; D015999:Multivariate Analysis; D010447:Peptide Hydrolases / Q000032:analysis; D011183:Postoperative Complications; D013923:Thromboembolism / Q000209:etiology; D010959:Tissue Plasminogen Activator / Q000097:blood; D020246:Venous Thrombosis / Q000097:blood* / Q000175:diagnosis / Q000209:etiology*
C046193:antithrombin III-protease complex; D000990:Antithrombin III; D005340:Fibrinogen; D010447:Peptide Hydrolases; D015956:Factor XIIa; D010959:Tissue Plasminogen Activator