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Case Report
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| Successful laparoscopic radical prostatectomy in a patient with factor XI deficiency | ||||||
| Mihály Murányi1, Mátyás Benyó2, Zoltán Kiss3, Tibor Flaskó4 | ||||||
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1MD, Clinician, Department of Urology, University of Debrecen, Debrecen, Hungary.
2MD PhD, Assistant professor, Department of Urology, University of Debrecen, Debrecen, Hungary. 3MD, Resident, Department of Urology, University of Debrecen, Debrecen, Hungary. 4MD PhD, Head of the department, Department of Urology, University of Debrecen, Debrecen, Hungary. | ||||||
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| How to cite this article |
| Murányi M, Benyó M, Kiss Z, Flaskó T. Successful treatment of Hepatitis C virus infection in a renal transplant patient with ribavirin and sofosbuvir: A case report. Int J Case Rep Images 2016;7(6):374–377. |
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Abstract
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Introduction:
Factor XI deficiency is a rare type of hemophilia. It is associated with profuse bleeding after traumas and surgical procedures. In a patient with factor XI deficiency, the serum coagulation factor level does not predict bleeding tendency appropriately. Operations in sites without fibrinolytic activity are less likely to be complicated by bleeding, while surgery in areas with fibrinolytic activity, like prostatectomy, increases the risk of bleeding. The optimal treatment should be determined by individual circumstances. Radical prostatectomy is a procedure when severe bleeding requiring transfusion can occur even without any bleeding disorder. At the same time radical prostatectomy carries a significant risk of potentially fatal thromboembolism. Thus keeping the balance between procoagulant and anticoagulant activity is the challenging part in cases of radical prostatecomy of factor XI deficiency.
Case Report: A 67-year-old patient is presented with organ confined intermediate-risk prostate cancer. Prolonged bleeding after tooth extraction and prostate biopsy indicated assessment of hemostatic system. Laboratory tests revealed factor XI deficiency. Successful laparoscopic extraperitoneal radical prostatectomy and bilateral pelvic lymphadenectomy was performed with low amount of blood loss. Recombinant activated coagulation factor VII was administered to prevent perioperative bleeding. The postoperative period was uneventful, no complications were observed. Conclusion: Despite the high risk of hemorrhage, laparoscopic radical prostatectomy is a feasible procedure even in a patient with factor XI deficiency, providing that the patient receive adequate preparation and a meticulously performed operation carried out by an experienced surgeon. | |
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Keywords:
Factor XI deficiency, Hemophilia, Laparoscopy, Radical prostatectomy
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Author Contributions
Mihály Murányi – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Mátyás Benyó – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Zoltán Kiss – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Tibor Flaskó – Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2016 Mihály Murányi et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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About The Authors
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