PREOPERATIVE AND POSTOPERATIVE STATE OF COAGULATION AND FIBRINOLYSIS IN PLASMA OF PATIENTS WITH BENIGN AND MALIGNANT COLORECTAL DISEASE - APRELIMINARY-STUDY

This study was carried out in order to compare the coagulation balance in patients with colorectal cancer before and after surgical removal of tumor with an age matched non-malignancy control group, Furthermore , it was studied whether preoperative coagulation state in cancer pati ents was correlated to the postoperative development of deep venous th rombosis (DVT) diagnosed by venography. Plasma was collected preoperat ively in 93 cancer patients and 30 controls, and postoperatively on da y one, two, seven, and ninety in 88 cancer patients and 18 controls. P rothrombin fragment 1 + 2 (F1 + 2), thrombinan-tithrombin complex (TAT ), and total fibrin(ogen) degradation products (TDP) were quantitated in plasma by enzyme linked immunosorbent assays (ELISA). As compared t o controls, patients admitted for cancer treatment displayed significa ntly higher levels of F1 + 2 and TAT. Patients suffering from advanced colorectal cancer had significantly higher levels of TAT and TDP as c ompared to patients with localized colorectal cancer. Twenty-three per cent of cancer patients developed DVT postoperatively. Preoperatively these patients displayed significantly higher TDP levels, and postoper atively higher levels of F1 + 2, TAT, and TDP compared to cancer patie nts without DVT. The marked activation of blood coagulation and fibrin olysis observed in all patients following major abdominal surgery was even more pronounced in patients not cured for cancer.