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首页> 外文期刊>Surgical Endoscopy >Videolaparoscopic cholecystectomy induces a hemostasis activation of lower grade than does open surgery.
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Videolaparoscopic cholecystectomy induces a hemostasis activation of lower grade than does open surgery.

机译：与开放手术相比，视频腹腔镜胆囊切除术可引起较低级别的止血激活。

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BACKGROUND: Tissue injury after trauma and surgery may induce alterations in blood coagulation and fibrinolysis, and the hypercoagulable state observed after surgery can be associated with the risk of postoperative thromboembolic complications. Recently, videolaparoscopic (VLPS) cholecystectomy has been introduced, and its advantages over the open procedure seem related to the reduced surgical trauma. The aim of this study was to investigate hemostatic system alterations in patients who undergo open and VLPS cholecystectomy. METHODS: Fibrinogen, prothrombin fragment F1+2, D-dimer, and plasminogen activator inhibitor type-1 (PAI-1) activity was determined in 10 patients who underwent open (group A) and 10 patients who underwent VLPS cholecystectomy (group B), respectively. Blood samples were obtained the day of surgery in the morning (B1), after anesthesia (A1), 1 hour after the start of surgery (S1), then 30 min (E.05) and 24 h (E.24) after the surgery. RESULTS: No significant differences were observed in baseline values between groups A and B for the parameters investigated. At 24 h after surgery, fibrinogen increased significantly (p < 0.05) in group A and also was significantly higher than in group B (p < 0.05). In group A, a marked increase in F1+2 levels (p < 0.01) was observed in all the samples, with the maximum values on the first day after surgery (3.7 nmol/l; 1.2-6.0 nmol/l), whereas in group B, a slight but significant increase in F1+2 levels (2.1 nmol/l; 1.1-3.9 nmol/l; p < 0.01) was observed only 30 min after the end of surgery. In both groups A and B, D-dimer markedly increased after surgery, without statistical significant differences between the two groups at any time. The PAI-1 activity plasma levels remained in the normal range during and after surgery in both groups. CONCLUSIONS: These results indicate that VLPS surgery induces an activation of the clotting system that, although of low degree and short duration, can lead to a transient prothrombotic state.
机译：背景：创伤和手术后的组织损伤可能引起血液凝固和纤维蛋白溶解的改变，并且手术后观察到的高凝状态可能与术后血栓栓塞并发症的风险有关。最近，已经引入了视频腹腔镜（VLPS）胆囊切除术，它比开放手术的优势似乎与减少手术创伤有关。这项研究的目的是调查接受开腹和VLPS胆囊切除术的患者的止血系统改变。方法：确定10例行开腹手术的患者（A组）和10例行VLPS胆囊切除术的患者（B组）的纤维蛋白原，凝血酶原片段F1 + 2，D-二聚体和纤溶酶原激活物抑制剂1型（PAI-1）活性。 ， 分别。在手术当天（B1），麻醉后（A1），手术开始后1小时（S1），手术后30分钟（E.05）和手术后24小时（E.24）采集血样。手术。结果：对于所研究的参数，A组和B组之间的基线值没有观察到显着差异。手术后24小时，A组的纤维蛋白原显着增加（p <0.05），也显着高于B组（p <0.05）。在A组中，在所有样品中均观察到F1 + 2水平显着增加（p <0.01），在手术后的第一天达到最大值（3.7 nmol / l; 1.2-6.0 nmol / l），而在B组在手术结束后仅30分钟观察到F1 + 2水平轻微但显着升高（2.1 nmol / l; 1.1-3.9 nmol / l; p <0.01）。在A组和B组中，手术后D-二聚体均显着增加，两组之间在任何时候均无统计学差异。两组在手术期间和之后，PAI-1活性血浆水平均保持在正常范围内。结论：这些结果表明，VLPS手术可诱导凝血系统激活，尽管凝血程度低且持续时间短，但可导致短暂的血栓形成状态。

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