Evaluation of markers of deep vein thrombosis in patients undergoing surgery for maxillofacial malignancies

During and following significant surgical intervention, deep venous thrombo sis 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 pulmona ry embolism. The present study focuses on appraising modern markers of deep vein thrombosis in 34 patients undergoing major maxillofacial surgery, wit h 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 da y plasm a levels of the coagulation indicator thrombin-antithrombin-III com plexes were significantly higher in the group of tumour patients. Markers o f fibrinolysis indicated corresponding results: on the first postoperative day tissue-plasminogen activator values rose to 18.9+/-3.2 mu g/l in the gr oup of malignant patients, but only to 7.4+/-1.1 mu g/l (P<0.05) in the con trol group. Also postoperative D-dimer concentrations in the malignancy gro up were significantly above those of the control group, In the present study it could be demonstrated that patients,vith malignant neoplasia undergoing major maxillofacial surgery are exposed postoperativel y to a particularly high risk of de,eloping thromboembolic complications. A ll in all, the status of anti-thrombotic therapy requires reappraisal with respect to the current treatment approach adopted in tumour patients.