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腹腔镜手术后与开放手术后的血液凝固术后变化:狼疮抗凝剂的作用。

Hemocoagulative post-operative changes after laparoscopic surgery compared to open surgery: the role of lupus anticoagulant.

机构信息

Department of Surgery, University of Catania, Catania, Italy.

Department of Medical Sciences, Surgical Sciences and Advanced Technologies, Hemostasis Unit, University of Catania, Catania, Italy.

出版信息

Updates Surg. 2020 Dec;72(4):1223-1227. doi: 10.1007/s13304-020-00724-7. Epub 2020 Mar 13.

Abstract

Although still debated, post-operative modification of hemostasis seems to be less pronounced after laparoscopy compared to open surgery. Antiphospholipid antibodies might play a role in the post-operative thromboembolic risk, although their evaluation in surgical patients has never been performed. Post-operative modification of antiphospholipid antibodies could be related to the surgical approach (laparoscopic or open). In this prospective study, the authors statistically compared the pre-operative values and post-operative modification of antiphospholipid antibodies in two homogeneous groups of patients operated on by laparoscopic and open surgery. No statistical differences within each group and between the two groups were shown comparing mean values of pre-operative and post-operative antiphospholipid antibodies. In the open group, there was a significant difference between pre-operative and post-operative LAC means (P < 0.01). In the laparoscopic group, on the contrary, no significant change in LAC values between pre- and post-operative tests (P = 0.55) was observed. Since LAC could be related to coagulation disorders, this study seems to support that laparoscopic surgery might induce a less risk of post-operative thromboembolic disease.

摘要

尽管仍存在争议,但与开放手术相比,腹腔镜手术后止血的改变似乎不那么明显。抗磷脂抗体可能在术后血栓栓塞风险中起作用,尽管从未对手术患者进行过此类评估。抗磷脂抗体的术后改变可能与手术方法(腹腔镜或开放)有关。在这项前瞻性研究中,作者对腹腔镜和开放手术的两组同质患者的术前值和术后抗磷脂抗体的改变进行了统计学比较。两组之间和每组内的平均术前和术后抗磷脂抗体值比较均无统计学差异。在开放组中,术前和术后 LAC 均值之间存在显著差异(P<0.01)。相反,在腹腔镜组中,术前和术后测试之间 LAC 值没有明显变化(P=0.55)。由于 LAC 可能与凝血障碍有关,因此本研究似乎表明腹腔镜手术可能会降低术后血栓栓塞疾病的风险。

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