Document Detail

The peritoneal fibrinolytic response to conventional and laparoscopic colonic surgery.
MedLine Citation:
PMID:  19670975     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Laparoscopic surgery is considered to induce less peritoneal trauma than conventional surgery. The peritoneal plasmin system is important in the processes of peritoneal healing and adhesion formation. The present study assessed the peritoneal fibrinolytic response to laparoscopic and conventional colonic surgery. METHODS: Twenty-four patients scheduled for a right colonic resection were enrolled in the trial. Twelve underwent conventional surgery and 12 were operated laparoscopically. Biopsies of the parietal peritoneum were taken at standardized moments during the procedure. Tissue concentrations of tissue-type plasminogen activator (tPA) and its specific activity (tPA-activity), urokinase-type plasminogen activator (uPA), and plasminogen activator inhibitor type 1 (PAI-1) were measured, using commercial assays. RESULTS: After mobilization of the colon, peritoneal levels of tPA antigen and activity were significantly higher in the laparoscopic group (p < 0.005) due to a decrease in the conventional group (p < 0.05). At the end of the procedure, the concentrations of tPA antigen and activity significantly (p < 0.05) decreased in the laparoscopic group to levels comparable with the conventional group. Neither uPA antigen nor PAI-1 antigen changed throughout the procedures. CONCLUSIONS: Both conventional and laparoscopic surgery inflict a decrease in tPA antigen and its specific activity. Peritoneal hypofibrinolysis initiates more rapidly during conventional, compared to laparoscopic, surgery, but at the conclusion of the surgery, the effect was the same.
Walter Brokelman; Lena Holmdahl; Peter Falk; Jean Klinkenbijl; Michel Reijnen
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of laparoendoscopic & advanced surgical techniques. Part A     Volume:  19     ISSN:  1092-6429     ISO Abbreviation:  J Laparoendosc Adv Surg Tech A     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-08-12     Completed Date:  2009-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706293     Medline TA:  J Laparoendosc Adv Surg Tech A     Country:  United States    
Other Details:
Languages:  eng     Pagination:  489-93     Citation Subset:  IM    
Department of Surgery, Alysis Zorggroep, Locatie Rijnstate, Graaf Lodewijkstraat 1546-6, Arnhem, The Netherlands.
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MeSH Terms
Aged, 80 and over
Colectomy / methods*
Colitis / metabolism,  pathology,  surgery*
Colonic Neoplasms / metabolism,  pathology,  surgery*
Fibrinolysis / physiology*
Middle Aged
Peritoneum / metabolism*,  pathology
Plasminogen Activator Inhibitor 1 / metabolism
Tissue Polypeptide Antigen / metabolism
Urokinase-Type Plasminogen Activator / metabolism
Reg. No./Substance:
0/Plasminogen Activator Inhibitor 1; 0/Tissue Polypeptide Antigen; EC Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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