[Effects of preoperative acute hypervolemic hemodilution on hypercoagulability of patients with colon cancer]

Cancer patients have an increased risk of thrombosis after operation because of a hypercoagulable status. Therefore, anticoagulant treatment is necessary for patients with hypercoagulability during perioperative period. This study was to investigate the effect of acute hypervolemic hemodilution (AHHD) with 6% hydroxyethyl starch (HES), or 4% succinylated gelatin (GEL), or lactated Ringer's (RL) solution before operation on the hypercoagulable status and the occurrence of deep venous thrombosis (DVT) of patients with colon cancer.

Sixty colon cancer patients with hypercoagulable status underwent operation were randomized into HES, GEL, and RL groups; each group contained 20 patients. The patients were infused with HES, GEL, or RL solution respectively at a dose of 15 ml/kg within 30 min before operation. Preoperative coagulation function was assessed by thrombelastography (TEG). DVT was diagnosed by the color Doppler ultrasonic system.

Acute hypervolemic hemodilution with HES solution led to a significant decrease of coagulation index (CI) at 30 min and 2 h after starting operation and 1 h after operation as compared with the prehemodilution value (P<0.01). At 1 h after operation, CI was significantly lower in HES group than in GEL group (P<0.05). At 30 min and 2 h after starting operation and 1 h after operation, CI was significantly lower in HES group than in RL group (P<0.05). Hemodilution with GEL solution lessened CI at 30 min and 2 h after starting operation significantly as compared with the prehemodilution value (P<0.01). At 30 min and 2 h after starting operation, CI was significantly lower in GEL group than in RL group (P<0.05). After operation, DVT in occurred 2 (10%) patients in HES group, 3 (15%) in GEL group, and 10 (50%) in RL group (P<0.05).

Acute hypervolemic hemodilution with HES solution and GEL solution can alleviate the hypercoagulability of colon cancer patients during perioperative period and decrease the occurrence of DVT.