腹腔镜与传统结直肠切除术对腹膜纤溶能力的影响：一项前瞻性随机临床试验
Effect of laparoscopic and conventional colorectal resection on peritoneal fibrinolytic capacity: a prospective randomized clinical trial.
作者信息
Neudecker J, Junghans T, Ziemer S, Raue W, Schwenk W
机构信息
Department of General, Visceral, Vascular, and Thoracic Surgery, Medical Faculty, Humboldt University, Charité Campus Mitte, Schumannstrasse 20/21, 10117 Berlin, Germany.
出版信息
Int J Colorectal Dis. 2002 Nov;17(6):426-9. doi: 10.1007/s00384-002-0391-x. Epub 2002 Apr 9.
BACKGROUND AND AIMS
Reduced fibrinolytic activity of the peritoneum seems to be the main cause of postoperative adhesions. This prospective randomized trial compared the peritoneal fibrinolytic activity between laparoscopic and conventional colorectal resection.
METHODS
Parietal peritoneal biopsy specimens were taken in standardized elective laparoscopic ( n=14) and conventional ( n=16) colorectal resections at the beginning and at the end of surgery. Activities and concentrations of tissue-plasminogen activator (tPA), plasminogen activator (PAI) type 1, and tPA/PAI complex were determined by ELISA kits.
RESULTS
There was no difference in age, sex, or body mass index between the two groups. Perioperative tPA activity decreased in both groups without differences between the groups. Concentrations and activities of tPA, PAI-1, and tPA/PAI complex did not differ between the groups at any time.
CONCLUSION
Peritoneal concentrations and activities of tPA, PAI-1, and tPA/PAI complex are similar during laparoscopic and conventional colorectal resections. A capnoperitoneum of 12 mmHg over 3 h did not affect the peritoneal fibrinolytic activity
背景与目的
腹膜纤溶活性降低似乎是术后粘连的主要原因。这项前瞻性随机试验比较了腹腔镜结直肠切除术和传统结直肠切除术之间的腹膜纤溶活性。
方法
在标准化择期腹腔镜结直肠切除术（n = 14）和传统结直肠切除术（n = 16）中，于手术开始时和结束时获取壁腹膜活检标本。通过酶联免疫吸附测定试剂盒测定组织型纤溶酶原激活剂（tPA）、1型纤溶酶原激活剂抑制物（PAI）以及tPA/PAI复合物的活性和浓度。
结果
两组在年龄、性别或体重指数方面无差异。两组围手术期tPA活性均降低，且组间无差异。两组在任何时间点的tPA、PAI-1以及tPA/PAI复合物的浓度和活性均无差异。
结论
在腹腔镜结直肠切除术和传统结直肠切除术中，腹膜tPA、PAI-1以及tPA/PAI复合物的浓度和活性相似。3小时内12 mmHg的气腹压力并未影响腹膜纤溶活性。
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