Surgery in Polycythemia Vera

Abstract

THE course of polycythemia vera is complicated by hemorrhagic and thromboembolic phenomena of varying severity occurring in about a third of the cases. These complications have been ascribed to the hypervolemia and increased red-cell mass, with resultant sluggish blood flow, capillary distention with poor retractability, thrombocytosis and a complex hemostatic defect manifested by ineffective clot formation despite the presence of normal or increased cellular and plasma coagulation factors.Surgical procedures for coincidental or complicating diseases appear to be accompanied by an excessively high morbidity and mortality. Although the dangers of surgery in polycythemia vera have been noted^{1 2 3 4 5 6 7 8} there is little . . .