The usefulness high-dose heprin therapy for the prevention of thrombus formation during endoscopic surgery

  • Furuta Kazunori
    Department of Surgery, Kitasato University School of Medicine, National Okura Hospital National Center of Child Health and Development
  • Tsuchihasi Seiichiro
    Department of Surgery, Kitasato University School of Medicine, National Okura Hospital National Center of Child Health and Development
  • Nemoto Yuta
    Department of Surgery, Kitasato University School of Medicine, National Okura Hospital National Center of Child Health and Development

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  • 腹腔鏡下手術における血栓予防としての高濃度ヘパリンの有用性

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Laparoscopic surgery has now become popular for a number of different procedures. This minimally invasive approach, however, is occasionally associated with serious hemorrhagic events, such as deep vein thrombosis and pulmonary infarction. At our department, we administer high-dose heparin therpy during endoscopic surgical interventions. The aim of this retrospective study was to clarify the usefulness of such high-dose heparin therapy during endoscopic surgical procedures. For this purpose, we compared the parameters of coagulation and fibrinolysis before and after surgical interventions in 69 patients who received intraoperative high-dose heprain therapy (the heparin group) and 9 patients who did not receive such therapy (the non-heparin group) at our department. The postoperative prothrombin time (PT) and thrombo test (TT) were found to be significantly decreased in the heparin group as compared to the values in the non-heparin group. No postoperative elevations in the levels of fibrin and fibrinogen degradation products (FDPs), thrombin-antithrombin III complex (TAT) or D-dimers were observed in the heparin group. In the non-heparin group, however, these parameters were found to be significantly increased postopertively as compared to the preoperative value. Parameters of coagulation and fibrinolysis tend to fluctuate under the pneumoperitoneal condition. The results of this study showed that intraoperative heparin infusion significantly attenuated unfavorable changes of these parameters, suggesting that intraoperative heparin might contribute to the prevention of thrombus formation in patients undergoing endoscopic surgical procedures.

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