Thromb J. 2017 Dec 20;15:29. doi: 10.1186/s12959-017-0152-2. eCollection 2017.

Video-assisted Thoracoscopic surgery (VATS) lobectomy for lung cancer does not induce a procoagulant state.

Christensen TD1,2, Vad H1,2, Pedersen S3,2, Licht PB4, Nybo M5, Hornbech K6, Zois NE7, Hvas AM8,2.

Author information

1

Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, DK - 8200 Aarhus N, Denmark.

2

Department of Clinical Medicine, Aarhus University Hospital, DK - 8200 Aarhus N, Denmark.

3

Department of Anesthesiology and Intensive Care, Aarhus University Hospital, DK - 8200 Aarhus N, Denmark.

4

Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, DK - 5000 Odense C, Denmark.

5

Department of Clinical Biochemistry, Odense University Hospital, DK - 5000 Odense C, Denmark.

6

Department of Cardio-thoracic Surgery, Rigshospitalet, Copenhagen University Hospital, DK - 2100 Copenhagen, Denmark.

7

Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, DK - 2100 Copenhagen, Denmark.

8

Department of Clinical Biochemistry, Aarhus University Hospital, DK - 8200 Aarhus N, Denmark.

Abstract

BACKGROUND:

Changes in the coagulation system in patients undergoing surgery for lung cancer have been sparsely investigated and the impact of the surgical trauma on the coagulation system is largely unknown in these patients. An increased knowledge could potentially improve the thromboprophylaxis regimes. The aim of this study was to assess the coagulation profile evoked in patients undergoing curative surgery by Video-Assisted Thoracoscopic Surgery (VATS) lobectomy for primary lung cancer.

METHODS:

Thirty-one patients diagnosed with primary lung cancer undergoing VATS lobectomy were prospectively included. The coagulation profile was assessed preoperatively and in the first two days postoperatively using a wide range of standard coagulation tests, dynamic whole blood coagulation measured by rotational thromboelastometry (ROTEM®) and thrombin generation evaluated by calibrated automated thrombography. Patients did not receive thromboprophylactic treatment. Data was analyzed using repeated measures one-way ANOVA.

RESULTS:

The standard coagulation parameters displayed only subtle changes after surgery and the ROTEM® and thrombin generation results remained largely unchanged.

CONCLUSIONS:

Patients undergoing VATS lobectomy are normocoagulable in the preoperative state and a VATS lobectomy does not significantly influence the coagulation.