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Prostatectomy in an 85-year-old hemophiliac
Archives of Surgery (Chicago, Ill. : 1960)
|July 1, 1976
Summary
This study highlights successful management of a mild hemophilia patient undergoing prostatectomy using factor VIII concentrate. Continuous infusion was crucial, as cessation led to post-operative bleeding, emphasizing factor VIII
Area of Science:
- Hematology
- Surgical Oncology
Background:
- Hemophilia management has advanced, enabling major surgeries.
- Prostatectomy in hemophiliacs requires consideration of factor VIII deficiency, fibrinolysis, and DIC.
Observation:
- An octogenarian with mild hemophilia and benign prostatic hypertrophy underwent suprapubic prostatectomy.
- Treatment involved antihemophilic factor (factor VIII) concentrate infusions during and after surgery.
Findings:
- Post-operative bleeding occurred when factor VIII infusions were stopped on day 15.
- Resuming factor VIII infusions successfully controlled the bleeding.
- Tests for abnormal fibrinolysis and fibrin split products were negative.
Implications:
- Sustained factor VIII support is critical for preventing post-operative bleeding in hemophiliac patients undergoing prostatectomy.
- This case demonstrates the efficacy of factor VIII concentrate in managing surgical risks in elderly hemophiliacs.
- Careful monitoring and management of factor VIII levels are essential for successful surgical outcomes in patients with bleeding disorders.