Related Experiment Video
Updated: May 21, 2025
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Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
Published on: November 15, 2024
147
Patients Undergoing Oesophageal Cancer Surgery Do Not Have Impaired Haemostasis
Tua Gyldenholm1,2, Nina Madsen3, Niels Katballe2,4
1Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.
Summary
Oesophagectomy patients rarely experienced severe bleeding or required transfusions. Hemostasis remained intact throughout the perioperative period, indicating no impairment during this major cancer surgery.
Area of Science:
- Oncology
- Surgical Pathology
- Hematology
Background:
- Oesophagectomy is a significant oncological surgery with variable bleeding risks.
- The role of impaired hemostasis in perioperative bleeding following oesophagectomy is not fully understood.
- Investigating coagulation dynamics is crucial for managing surgical bleeding.
Purpose of the Study:
- To comprehensively assess perioperative coagulation in patients undergoing oesophagectomy for cancer.
- To determine if impaired hemostasis contributes to bleeding during and after oesophagectomy.
- To evaluate dynamic global hemostasis using thromboelastometry and platelet aggregation assays.
Main Methods:
- Prospective study of 87 adult patients with oesophageal adenocarcinoma or squamous cell carcinoma.
- Measurement of operative bleeding volume and blood transfusions.
- Analysis of blood samples using rotational thromboelastometry (ROTEM®), Multiplate Analyzer® for platelet aggregation, and routine coagulation tests at three time points.
Main Results:
- Median blood loss was 300 mL; severe bleeding (>1000 mL) was uncommon.
- Only 16% of patients received blood transfusions.
- Platelet aggregation and ROTEM® analyses indicated intact hemostasis with no significant perioperative decrease in clot formation or strength.
Conclusions:
- Severe perioperative bleeding and the need for blood product transfusions are rare in oesophagectomy.
- Patients undergoing oesophagectomy for cancer maintain intact hemostasis.
- Impaired hemostasis does not appear to be a significant factor in perioperative bleeding for this patient group.
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