Torakochirurgia
Non-small cell lung cancer: patients after pneumonectomy require longer anticoagulant prophylaxis than after lobectomy

Background:
Surgical treatment of cancer is associated with the risk of thromboembolism. The question is: might the range of lung resection in patients operated on for non-small cell lung cancer (NSCLC) have an influence on the serum anticoagulant protein expression?

Aim:
To compare the blood coagulation activation in patients after pneumonectomy and lobectomy based on concentration of selected proteins in serum.

Material and methods:
A prospective study was carried out among a group of 40 patients: Thirty of them underwent lobectomy and ten pneumonectomy. In all cases the serum level of tissue factor (TF), tissue factor pathway inhibitor (TFPI), tissue factor pathway inhibitor/activated factor X complex (TFPI/Xa), thrombin-antithrombin complex (TAT), L-selectin, E-selectin,
P-selectin were measured on the 1st and 7th postoperative day.

Results:
The results of selected protein levels obtained on the first day after surgery were similar in both groups. However, a significant increase of TF, TAT complex and E-selectin on the seventh postoperative day was detected in patients after pneumonectomy.

Conclusions:
Patients after pneumonectomy for NSCLC are at significantly higher risk of thromboembolism than patients after lobectomy. This suggests that antithrombotic prophylaxis should be prolonged in patients after pneumonectomy.