A Case of Hemophilia a with Multiple Surgeries for Different Gastrointestinal Malignancy

Abstract

Hemophilia A is a recessive genetic disorder characterized by congenital bleeding disorder due to deficiency of coagulation factor VIII. Patients with hemophilia A are rarely encountered, and multiple surgeries for them have rarely been reported. In this report, we describe our experience of performing three gastrointestinal surgeries on a patient with hemophilia A in a short period of time, with a focus on perioperative management and some discussion of the literature. The case involved a 79-year-old man who had been attending our hematology department for hemophilia A (coagulation factor activity trough value : 7-9% ; mild disease). He underwent a laparoscopic proximal gastrectomy for gastric cancer in August 2021, a laparoscopic ileocolic resection for ascending colon cancer in January 2022, and a laparoscopic partial hepatectomy for metastatic liver cancer (colorectal cancer) in August 2022. The patient was discharged from the hospital without any postoperative complications at every surgery, and there was no incidence of allogeneic antibodies associated with repeated coagulation factor infusions during the three surgeries. By supplementing with appropriate Factor VIII preparations based on the guideline, a patient with hemophilia A can be safely operated on in the same way as healthy people.