Peritoneal fibrinolytic response to various aspects of laparoscopic surgery: a randomized trial.

• BACKGROUND: Peritoneal fibrinolysis is important in peritoneal wound healing processes and adhesion formation. The peritoneal fibrinolytic response to laparoscopy is merely unknown. In the present study we investigate the effect of short-term laparoscopy on the peritoneal fibrinolytic response and the influence of intra-abdominal pressure, light intensity and choice of dissection device on this response. METHODS: There were 50 patients scheduled for laparoscopic cholecystectomy randomized in five groups operated with various pressures, light intensities, and dissection devices. Peritoneal biopsies were taken at the beginning and the end of the procedure. Tissue concentrations of tissue-type plasminogen activator (tPA), urokinase-type plasminogen activator (uPA), plasminogen activator inhibitor type 1 (PAI-1), and the tPA-activity were measured using ELISA techniques. RESULTS: There were no differences in tPA antigen, tPA-activity, uPA antigen, or PAI-1 antigen concentrations in biopsies taken at the beginning compared to samples taken at the end of the operation. Different intra-abdominal pressures, light intensities and the choice dissection device did not affect any of the measured parameters. CONCLUSION: Short-term laparoscopy does not affect the peritoneal fibrinolytic activity. The used intra-abdominal pressure, light intensity and choice of dissection device do not affect peritoneal activity during short-term laparoscopy.

Nyckelord

Adhesions

metabolism

Adult

Aged

Cholecystectomy

Laparoscopic

methods

Dissection

Electrocoagulation

Enzyme-Linked Immunosorbent Assay

Female

Fibrinolysis

Humans

Lighting

Male

Middle Aged

Peritoneum

metabolism

physiology

surgery

Plasminogen Activator Inhibitor 1

metabolism

Pressure

Tissue Plasminogen Activator

metabolism

Urinary Plasminogen Activator

metabolism

Wound Healing

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)