[Effect of pneumoperitoneum on plasminogen activator activity in the abdomen]

In a study in pigs it was examined whether peritoneal plasminogen activator activity (PAA) is impaired by creation of a pneumoperitoneum (PP) with CO2 or with helium. The animals were anesthetised and laparotomised, and peritoneal biopsies were taken from the cecum, the ileum and the wound site. Then a PP of 15 mmHg was created with CO2 (Grp. 1, n = 6) or helium (Grp. 2, n = 6). Group 0 (n = 7) was left without gas insufflation. After a PP of 3 hrs and an additional observation period of 2 hrs further tissue samples were collected. In the biopsies specific PAA was determined. In all groups a decrease of specific PAA occurred. However, at the end of the experiment PAA was significantly lower in the cecum of the CO2-group (24.3 U/mg, 32.4%) when compared to the controls without gas (75.1 U/mg, 100%) or the helium group (65.1 U/mg 86.7%). Our data raise suspicion that insufflation of CO2 for laparoscopic intervention may enhance the risk of peritoneal adhesions by a suppression of PAA.