Modifications of coagulation and fibrinolytic parameters in laparoscopic cholecystectomy

被引:79
作者
Vecchio, R
Cacciola, E
Di Martino, M
Cacciola, RR
MacFadyen, BV
机构
[1] Catania Univ, Vittorio Emanuele Hosp, Dept Surg, I-95100 Catania, Italy
[2] Univ Catania, Ferrarotto Hosp, Dept Biomed Sci, Sect Hematol, I-95100 Catania, Italy
[3] Univ Texas, Sch Med, Dept Surg, Houston, TX 77030 USA
来源
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 2003年 / 17卷 / 03期
关键词
laparoscopy; hemostasis; coagulation; fibrinolysis; platelet aggregation; thromboembolism;
D O I
10.1007/s00464-001-8291-7
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: The incidence of deep vein thrombosis and pulmonary embolism following laparoscopic surgery is unknown and studies on alterations of hemostasis after laparoscopy are inconclusive. Methods: In this study we prospectively evaluated changes in prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen (Fg), antithrombin III (ATIII), prothrombin fragment F 1 + 2, beta-thromboglobulin (betaTG) and D-dimer (D-D), preoperatively and 24 h after laparoscopic surgery in 16 patients. Results: Comparing pre- and postoperative values, no statistical differences were observed in aPTT, F1 + 2, and ATIII measurements. Postoperative PT values increased slightly (p similar to 0.05) after surgery. Conversely, Fg, betaTG, and D-D values were statistically higher in the 24-h evaluation (p = 0.008, 0.01, and 0.045, respectively). Conclusions: These data suggest that laparoscopic surgery induces activation of coagulation and fibrinolytic pathways and, additionaly, betaTG elevation, which has never been reported and might account for postoperative platelet activation and a greater risk of thrombogenicity. Therefore, routine thromboembolic prophylaxis in patients undergoing laparoscopic surgery is recommended.
引用
收藏
页码:428 / 433
页数:6
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