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Coagulation profile in patients undergoing video-assisted thoracoscopic lobectomy: A randomized, controlled trial

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BACKGROUND: Knowledge about the impact of Low-Molecular-Weight Heparin (LMWH) on the coagulation system in patients undergoing minimal invasive lung cancer surgery is sparse. The aim of this study was to assess the effect of LMWH on the coagulation system in patients undergoing Video-Assisted Thoracoscopic Surgery (VATS) lobectomy for primary lung cancer.

METHODS: Sixty-three patients diagnosed with primary lung cancer undergoing VATS lobectomy were randomized to either subcutaneous injection with dalteparin (Fragmin®) 5000 IE once daily or no intervention. Coagulation was assessed pre-, peri-, and the first two days postoperatively by standard coagulation blood test, thromboelastometry (ROTEM®) and thrombin generation.

RESULTS: Patients undergoing potential curative surgery for lung cancer were not hypercoagulable preoperatively. There was no statistically significant difference in the majority of the assessed coagulation parameters after LMWH, except that the no intervention group had a higher peak thrombin and a shorter INTEM clotting time on the first postoperative day and a lower fibrinogen level on the second postoperative day. A lower level of fibrin d-dimer in the LMWH group was found on the 1. and 2.postoperative day, although not statistical significant. No differences were found between the two groups in the amount of bleeding or number of thromboembolic events.

CONCLUSIONS: Use of LMWH administered once daily as thromboprophylaxis did not alter the coagulation profile per se. As the present study primarily evaluated biochemical endpoints, further studies using clinical endpoints are needed in regards of an optimized thromboprophylaxis approach.

Original languageEnglish
JournalP L o S One
Volume12
Issue number2
Pages (from-to)e0171809
ISSN1932-6203
DOIs
Publication statusPublished - 2017

    Research areas

  • Aged, Anticoagulants, Blood Coagulation, Female, Fibrin Fibrinogen Degradation Products, Fibrinogen, Heparin, Low-Molecular-Weight, Humans, Lung Neoplasms, Male, Middle Aged, Partial Thromboplastin Time, Postoperative Period, Thoracic Surgery, Video-Assisted, Thrombin, Thromboembolism, Journal Article, Randomized Controlled Trial

ID: 52044452