[COMORBID BURDEN AND RISK OF THROMBOHEMORRHAGIC COMPLICATIONS DURING SURGICAL TREATMENT OF PATIENTS WITH COLORECTAL CANCER].

In 30 patients with verified colorectal cancer (T2-4N0-2M0-1), who were planned and performed surgical intervention in order to prevent complications, including thrombohemorrhagic complications, comorbid burden was studied according to the Charlson questionnaire and the results of a functional test of the hemostasis system using low-frequency piezothromboelastography (LPTEG). The predicted relative risk (RR) of complications associated with the cardiovascular system (CVS) and thrombohemorrhagic complications (TGC) was high ((RRCVS=4.3; p=0.001), (RRTGC=3.2; p=0.017), respectively). In patients with III-IV stages of the disease, the results of LPTEG corresponded to the decompensated or depleted type of reaction of the hemostasis system (r=0.59; p=0.036). Depending on the revealed disorders in the hemostasis system, the patients used: antiplatelet agents, direct anticoagulants, bioflavinoids, cofactors of the components of the coagulation system, antifibrinolytic drugs. The use of the developed prophylaxis regimens showed a high protective effect: complications from CVS, TGC were not observed either during surgical treatment or in the postoperative period. At the same time, the total proportion of postoperative complications was 13.3%, including: in 3.3% of cases acute perforated ulcer of the ileum developed, in 3.3% - an eventration of the midline laparotomic wound, in 6.7% - coagulopathic bleeding in patients with liver metastases who underwent resection of the affected segments. For the prevention of coagulopathic bleeding, dynamic monitoring of the hemostasis system is required, using laboratory (complete blood count, coagulogram) and highly informative instrumental research methods (LPTEG), on the results of which the dosage and time of administration of anticoagulants will depend, and, if necessary, its cancellation due to risk of bleeding.