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Differences in perioperative coagulation between Japanese and other ethnic groups undergoing laparoscopic
1Department of Anesthesiology, Tokyo Women's Medical University, School of Medicine, 162-8666, 8-1, Kawatacho Shinjukuku, Tokyo, Japan. kmsti@pf6.so-net.ne.jp
Background:
Japanese patients experience fewer episodes of postoperative thrombosis than those in certain other countries. To investigate this phenomenon, we measured perioperative coagulation activation markers and conducted thromboelastography (TEG) in 27 Japanese patients undergoing laparoscopic cholecystectomy.
Methods:
D-dimer, thrombin-antithrombin complex (TAT), and prothrombin fragment 1+2 (F1+2) were measured as coagulation activation markers. TEG was performed to measure reaction time (R), clot formation time (K), maximum amplitude (MA), and maximum elastance (ME). These measurements were performed before and after the operation and the day after the operation.
Results:
Coagulation activation markers increased significantly postoperatively. With respect to TEG, MA and ME increased postoperatively. R and K did not change.
Conclusion:
Whereas clotting factor activation sthenia is common in Europe and North America, thrombocyte function sthenia occurs in Japanese patients. This difference may account for the differing incidences of phlebothrombosis in Japanese and white populations.