Failure in prophylactic management of thromboembolic disease in colorectal surgery

1988 ◽  
Vol 31 (5) ◽  
pp. 384-386 ◽  
Author(s):  
Peer Wille-Jørgensen ◽  
Johan Kjaergaard ◽  
Torben Jørgensen ◽  
Tommy Korsgaard Larsen
Keyword(s):  
Colorectal Surgery ◽  
Thromboembolic Disease

Laparoscopic Colorectal Surgery

1996 ◽  
Vol 83 (9) ◽  
pp. 1307-1307
Author(s):  
F. P. McGinn
Keyword(s):  
Colorectal Surgery ◽  
Laparoscopic Colorectal Surgery

Long-term survival after colorectal surgery associated with buffy-coat-poor and leucocyte-depleted blood transfusion: a follow-up study

The Lancet ◽  
2005 ◽  
Vol 365 (9460) ◽  
pp. 681-682 ◽  
Author(s):  
L JENSEN ◽  
E PUHO ◽  
L PEDERSEN ◽  
F MORTENSEN ◽  
H SORENSEN
Keyword(s):  
Colorectal Surgery ◽  
Blood Transfusion ◽  
Buffy Coat ◽  
Term Survival ◽  
Long Term Survival ◽  
Follow Up Study

Effective risk stratification of surgical and nonsurgical patients for venous thromboembolic disease

2001 ◽  
Vol 38 (2, Suppl 5) ◽  
pp. 12-19 ◽  
Author(s):  
Joseph A. Caprini ◽  
Juan I. Arcelus ◽  
Jos[eacute] J. Reyna
Keyword(s):  
Risk Stratification ◽  
Thromboembolic Disease ◽  
Venous Thromboembolic Disease ◽  
Venous Thromboembolic ◽  
Nonsurgical Patients

Monitoring Heparin Therapy: Relationships between the Activated Partial Thromboplastin Time and Heparin Assays Based on Ex-Vivo Heparin Samples

1990 ◽  
Vol 63 (01) ◽  
pp. 016-023 ◽  
Author(s):  
A M H P van den Bessekaar ◽  
J Meeuwisse-Braun ◽  
R M Bertina
Keyword(s):  
Partial Thromboplastin Time ◽  
Plasma Sample ◽  
Ex Vivo ◽  
Correlation Coefficients ◽  
Heparin Therapy ◽  
Thromboembolic Disease ◽  
Activated Partial Thromboplastin Time ◽  
Venous Thromboembolic Disease ◽  
Venous Thromboembolic

SummaryFive different APTT reagents, two amidolytic anti-ITa assays, one amidoiytic anti-Xa assay, and one coagulometric anti-Xa/ anti-IIa assay were used to assess the effect of heparin in patients treated for venous thromboembolic disease. Good correlations were observed between lug-transformed APYE> determined with the various reagents (correlation coefficients: 0.92-0.96).Nevertheless there were important differences in the slopes of the lines of relationship between the APTT reagents.Good correlations were observed between the anti-Xa and anti-IIa assay results (correlation coefficients: 0.92-0.97). However, the amidolytic anti-Xa activity was significantly higher (p <0.001) than the two amidolytic anti-IIa activities. Less good correlations were observed between the log-transformed APTTs and the anti-Xa or anti-IIa activities (correlation coefficients: 0.64-0.78). The correlations were improved by transforming the APTT into APTT-ratio, i.e. the ratio of the patient’s APTT to the same patient’s APTT after removal of heparin from the plasma sample by means of ECTEOLA-cellulose treatment. The correlation coefficients of log (AFTT-ratio) with anti-Xa or anti-IIa ranged from 0.76 to 0.87.For both APTT and amidolytic heparin assay, the response to in vitro heparin was different from the response to ex vivo heparin.Therefore, equivalent therapeutic ranges should be assessed by using ex vivo samples rather than in vitro heparin. Because of the response differences between the APTT reagents, it is not adequate to define a therapeutic range for heparin therapy without specification of the reagent.

The Mechanism of Platelet Aggregation Induced by HLA-Related Antibodies

1996 ◽  
Vol 76 (05) ◽  
pp. 774-779 ◽  
Author(s):  
John T Brandt ◽  
Carmen J Julius ◽  
Jeanne M Osborne ◽  
Clark L Anderson
Keyword(s):  
Platelet Aggregation ◽  
Platelet Activation ◽  
Complement Activation ◽  
Thromboembolic Disease ◽  
Clinical Samples ◽  
Hla Antigen ◽  
Aggregation Response ◽  
Immune Mediated ◽  
Dependent Pathway

SummaryImmune-mediated platelet activation is emerging as an important pathogenic mechanism of thrombosis. In vitro studies have suggested two distinct pathways for immune-mediated platelet activation; one involving clustering of platelet FcyRIIa, the other involving platelet-associated complement activation. HLA-related antibodies have been shown to cause platelet aggregation, but the mechanism has not been clarified. We evaluated the mechanism of platelet aggregation induced by HLA-related antibodies from nine patients. Antibody to platelet FcyRIIa failed to block platelet aggregation with 8/9 samples, indicating that engagement of platelet FcyRIIa is not necessary for the platelet aggregation induced by HLA-related antibodies. In contrast, platelet aggregation was blocked by antibodies to human C8 (5/7) or C9 (7/7). F(ab’)2 fragments of patient IgG failed to induce platelet activation although they bound to HLA antigen on platelets. Intact patient IgG failed to aggregate washed platelets unless aged serum was added. The activating IgG could be adsorbed by incubation with lymphocytes and eluted from the lymphocytes. These results indicate that complement activation is involved in the aggregation response to HLA-related antibodies. This is the first demonstration of complement-mediated platelet aggregation by clinical samples. Five of the patients developed thrombocytopenia in relationship to blood transfusion and two patients developed acute thromboembolic disease, suggesting that these antibodies and the complement-dependent pathway of platelet aggregation may be of clinical significance.

An Enzyme Linked Immunosorbent Assay for Determination of Tissue Plasminogen Activator Applied to Patients with Thromboembolic Disease

1983 ◽  
Vol 50 (03) ◽  
pp. 740-744 ◽  
Author(s):  
Nils Bergsdorf ◽  
Torbjörn Nilsson ◽  
Per Wallén
Keyword(s):  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Specific Activity ◽  
Thromboembolic Disease ◽  
Tissue Type ◽  
Enzyme Linked Immunosorbent Assay ◽  
Type Plasminogen Activator ◽  
Tissue Plasminogen ◽  
Normal Human

SummaryUtilizing the immunoglobulin fraction from a goat antiserum against human uterine tissue plasminogen activator, an enzyme- linked immunoassay for tissue-type plasminogen activator in human plasma has been developed. With the new method, the concentration of t-PA in normal human acidified plasma is found to be 4.0 ± 1.8 (SD) ng/ml. It increases to 12 ng/ml after a tomiquet test, and to 14 ng/ml after strenous physical exercise. In a group of patients with idiopathic thromboembolic disease, the resting t-PA concentration was 5 ng/ml and the post-occlusion value 16 ng/ml. Furthermore, the patients also exhibited a normal post-occlusion rise in the concentration of plasmin-α2-antiplasmin complex. However, in 37% of the post-occlusion patient plasmas, virtually no increase in t-PA could be detected by a specific activity assay. The results indicate that the reason for a defective post-occlusion fibrinolytic activity in a majority of cases may be the presence of increased concentrations of a fast-acting specific t-PA inhibitor.

THE FEASIBILITY OF FAST TRACK PROTOCOL FOR ELDERELY PATIENTS WITH COLORECTAL CANCER

2016 ◽  
pp. 26-29
Author(s):  
D. . Zitta ◽  
V. . Subbotin ◽  
Y. . Busirev
Keyword(s):  
Colorectal Cancer ◽  
Colorectal Surgery ◽  
Blood Loss ◽  
Elderly Patients ◽  
Fast Track ◽  
Randomized Study ◽  
Conventional Group ◽  
Intraoperative Blood Loss ◽  
Elective Colorectal Surgery ◽  
Complications Rate

Fast track protocol is widely used in major colorectal surgery. It decreases operative stress, shortens hospital stay and reduces complications rate. However feasibility and safety of this approach is still controversial in patients older than 70 years. The AIM of the study was to estimate the safety and effectiveness of fast track protocol in elderly patients with colorectal cancer. MATERIALS AND METHODS. Prospective randomized study included 138 elective colorectal resectionfor cancer during period from 1.01.10 till 1.06.15. The main criteria for the patients selection were age over 70 years and diagnosis of colorectal cancer. 82 of these patients received perioperative treatment according to fast track protocol, other 56 had conventional perioperative care. Patients underwent following procedures: right hemicolectomy (n=7), left hemicolectomy (n=12), transverse colectomy (n=1), sigmoidectomy (n=23), abdomeno-perineal excision (n=19) and low anterior resection of rectum (n=76). Following data were analized: duration of operation, intraoperative blood loss, time offirst flatus and defecation, complications rates. RESULTS. Mean age was 77,4 ± 8 years. There were no differences in gender, co morbidities, body mass index, types of operations between groups. Duration of operations didn't differ significantly between 2 groups. Intraoperative blood loss was higher in conventional group. The time of first flatus and defecation were better in FT-group. There was no mortality in FT-group vs 1,8 %o mortality in conventional group. Complications rate was lower in FT-group: wound infections 3,6% vs 9 %, anastomotic leakage 4,8 %o vs 9 %o, ileus 1,2 vs 5,4 %o, peritonitis 2,4 %o vs 3,6%o, bowel obstruction caused by the adhesions 6 % vs 5,3 %. Reoperation rate was similar 4,8 % vs 3,6 %. CONCLUSION. Fast track protocol in major elective colorectal surgery can be safely applied in elderly patients. The application of fast track protocol in elderly patients improves the restoration of bowel function and reduces the risk of postoperative complication.

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