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The operative peritoneal fibrinolytic response to abdominal operation
D M Scott-Coombes1, S A Whawell, J N Thompson
1Department of Surgery, Hammersmith Hospital, London, England.
Objective:
To measure changes in the fibrinolytic properties of human peritoneum during operation.
Design:
Open study.
Setting:
University hospital, UK.
Subjects:
20 patients undergoing elective operations for non-inflammatory disease.
Interventions:
Peritoneum was biopsied at the beginning and end of operation.
Main Outcome Measures:
Peritoneal plasminogen activating activity (PAA) and the concentrations of tissue plasminogen activator (t-PA), urokinase, and plasminogen activator inhibitors 1 and 2 were measured at both time points.
Results:
Peritoneal PAA was reduced over the time of the operation (p < 0.05) as was the concentration of t-PA (p < 0.05). The urokinase concentration rose significantly (p < 0.05), but plasminogen activator inhibitors 1 and 2 were not detected.
Conclusions:
Elective abdominal operation caused an immediate reduction in peritoneal PAA which seemed to be secondary to a reduced concentration of t-PA. Such a reduction in peritoneal fibrinolytic activity allows the early deposition of fibrinous deposits within the peritoneal cavity.