Decreased peritoneal tissue plasminogen activator during prolonged laparoscopic surgery.

• BACKGROUND: Peritoneal fibrinolysis is crucial in the peritoneal healing processes and subsequent adhesion formation. During conventional surgery, the peritoneal fibrinolytic system is rapidly disturbed. Short-term laparoscopy does not seem to affect peritoneal fibrinolysis. The aim of the present study was to assess the effect of prolonged laparoscopic surgery on peritoneal fibrinolysis. METHODS: Twelve consecutive patients undergoing laparoscopic gastric bypass surgery for morbid obesity were included in the study. During the procedure, biopsies of the parietal peritoneum were taken at the start of the procedure and each 45 min afterward. Tissue samples were homogenized and tissue-type plasminogen activator (tPA) antigen, tPA activity, urokinase-type PA antigen, and plasminogen activating inhibitors type 1 antigen were measured using commercial assay techniques. RESULTS: Both tPA antigen and its activity progressively decreased during the procedure, reaching significant levels after 90 min of surgery. The levels of uPA antigen and plasminogen activating inhibitors antigen did not significantly change throughout the procedure. CONCLUSIONS: As for conventional surgery, prolonged laparoscopic surgery causes a decreased fibrinolytic activity in the peritoneum due to decreased tPA levels.

Nyckelord

Adult

Biopsy

Female

Fibrinolysis

physiology

Gastric Bypass

methods

Humans

Laparoscopy

adverse effects

methods

Male

Middle Aged

Obesity

Morbid

surgery

Peritoneum

metabolism

pathology

Plasminogen Activator Inhibitor 1

metabolism

Retrospective Studies

Time Factors

Tissue Adhesions

physiopathology

Tissue Plasminogen Activator

metabolism

Urokinase-Type Plasminogen Activator

metabolism

Wound Healing

physiology

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)