Patients with solid malignancies who were not candidates for tumor resections in the past are now presenting for extensive\r\noncological resections. Cancer patients are at risk for thromboembolic complications due to an underlying hypercoagulable state;\r\nhowever, some patients may have an increased risk for bleeding due to the effects of chemotherapy, the administration of anticoagulant\r\ndrugs, tumor-related fibrinolysis, tumor location, tumor vascularity, and extent of disease. A common potential complication\r\nof all complex oncological surgeries is massive intra- and postoperative hemorrhage and the subsequent risk for massive blood\r\ntransfusion. This can be anticipated or unexpected. Several surgical and anesthesia interventions including preoperative tumor\r\nembolization, major vessel occlusion, hemodynamic manipulation, and perioperative antifibrinolytic therapy have been used to\r\nprevent or control blood loss with varying success. The exact incidence of massive blood transfusion in oncological surgery is\r\nlargely unknown and/or underreported. The current literature mostly consists of purely descriptive observational studies. Thus,\r\nrecommendation regarding specific perioperative intervention cannot be made at this point, and more research is warranted.
Loading....