Hypercoagulability after surgery of esophageal carcinoma

: The purpose of this study was to determine hypercoagulability in patients surgically treated for thoracic esophageal cancer. Twenty-four patients were evaluated; 19 subjected to open chest esophagectomy and 5 closed chest blunt dissection. Six patients subjected to gastrectomy served as controls. In all test patients, preoperative coagulability was within the normal range. Immediately after surgery, however, they were in a hypercoagulable state, showing a marked decrease in platelet count, prothrombin time, antithrombin III level and plasminogen level and an increase in activated partial thromboplastin time and fibrinopeptide B beta 15-42. The controls showed almost no change. There was a close correlation between hypercoagulability on one hand and the time needed for surgery and hemorrhage during 3rd to 7th postoperative day except those with multiple organ failure whose recovery was delayed and those with leakage of anastomosis whose condition did not improve even on the 10th postoperative day.