[The effect of Clexane (low-molecular-weight heparin) on the hemostatic system and on the incidence of postoperative thrombotic complications in gynecological cancer patients]. / Vliianie kleksana (nizkomolekuliarnogo geparina) na sistemu gemostaza i chastotu posleoperatsionnykh tromboticheskikh oslozhnenii u onkoginekologicheskikh bol'nykh.

Clexane in a dose of 40 mg before and after surgery notably decreased the intensity of chronic intravascular blood coagulation during surgical treatment of oncogynecological patients. Only 3% patients developed thrombosis of deep veins of the lower limbs after Clexane, while in the group administered no Clexane, 20% developed this complication. Preventive administration of Clexane did not cause an increase of the operative blood loss. The incidence of wound hematomas in patients administered Clexane and nonfractionated heparin was negligible and virtually the same.

[The diagnosis and correction of hemostatic system disorders during surgical coagulopathic hemorrhages in cancer patients]. / Diagnostika i korrektsiia narushenii sistemy gemostaza vo vremia operatsionnykh koagulopaticheskikh krovotechenii u onkologicheskikh bol'nykh.

The hemostasis system was examined before surgery, during the principal stages of the operative intervention, and in the early postoperative period in 280 patients with various malignant tumors. The volume of intraoperative blood loss varied from 280 to 14,000 ml. The studies revealed that the main factor causing the most profound disorders in the hemostasis system which lead to the development of grave coagulopathic hemorrhages is blood loss due to surgical trauma. Coagulopathic bleedings most frequently develop in case of at least a 3000 ml blood loss and course as different variants and stages of the syndrome of disseminated intravascular coagulation (DIC) or hemodilution coagulopathy. Massive blood loss was found to involve primarily damage of the platelet component of the hemostasis system, thrombocytopenia being paralleled by a drastic reduction of the aggregability of these cells, this, in turn, increasing bleeding from small vessels. Laboratory signs of acute DIC diagnosed during surgery anticipate its clinical manifestation. Working classification of operative bleedings and rapid methods for their diagnosis have been developed.

[Coagulopathic hemorrhages in the surgical treatment of cancer patients]. / Koagulopaticheskie krovotecheniia pri khirurgicheskom lechenii onkologicheskikh bol'nykh.

The hemostasis system was examined before surgery, during the principle stages of the intervention, and in the immediate postoperative period in 280 patients with various malignant tumors. The volume of blood loss during the operation varied from 280 to 14,000 ml. The studies demonstrated that blood loss due to traumatic surgical interventions is the principal factor causing the most profound disorders in the hemostasis system leading to the development of grave coagulopathic hemorrhages in cancer patients. Coagulopathic bleedings most frequently develop at a blood loss of more than 3,000 ml and course as variants and stages of the disseminated intravascular coagulation (DIC) syndrome or hemodilution coagulopathy. A massive blood loss was found to be detrimental primarily for the platelet component of the hemostasis system; besides thrombocytopenia, the aggregability of these cells reduced, this being conducive to development of hemorrhages from the small vessels. Laboratory signs of acute DIC syndrome diagnosed during surgery were shown to anticipate its clinical manifestation. A working classification of surgical hemorrhages and rapid methods for their diagnosis have been developed.

[The diagnosis and prevention of hemostatic system disorders in the surgical treatment of patients with cancer of the large intestine]. / Diagnostika i profilaktika narushenii sistemy gemostaza pri khirurgicheskom lechenii bol'nykh rakom tolstoi kishki.

The hemostasis system was studied before, during, and after surgery in 40 patients with colonic cancer administered no pretreatment and in 30 ones administered depogen before the operation and its combination with heparin after surgery. Preoperative depogen had a positive impact on both the coagulation and platelet components of the hemostasis. Depogen in complex with heparin reduced the intensity of subacute chronic intravascular blood coagulation during and after the operation and was conducive to a decrease of the incidence of postoperative complications in patients with colonic cancer.