SOLUBLE FIBRIN IN PLASMA BEFORE AND AFTER SURGERY FOR BENIGN AND MALIGNANT COLORECTAL DISEASE

In a prospective study, plasma levels of soluble fibrin (SF) were asse ssed in 97 patients with colorectal cancer immediately before and 1, 2 , 7, and 90 days after surgery, 18 patients undergoing surgery for ben ign colorectal disease serving as controls. Age distribution, routine blood analysis, duration of surgery, perioperative blood loss and anae sthesia was similar in the two groups. SF was quantitated using a comm ercial enzyme-linked immunosorbent assay. The preoperative plasma leve l of SF was normal in cancer patients as a whole. However, patients wi th disseminated colorectal cancer had higher levels of SF preoperative ly compared to patients with localized colorectal cancer (p<0.01) and controls (p<0.005). On days 1, 2, and 7 days postoperatively, a rather pronounced increase in plasma SF was observed in cancer patients as w ell as in the controls. Three months after surgery, plasma SF had norm alized in controls and in patients undergoing curative cancer treatmen t. Postoperative deep venous thrombosis (DVT) was detected in 23% of t he cancer patients by means of phlebography. The preoperative values o f SF in these patients were higher compared to patients not developing DVT (p<0.05). Patients with colon cancer displayed higher SF in plasm a than patients with rectal cancer (p<0.05).