Response of visceral peritoneum to abdominal surgery
- 1 January 2001
- journal article
- Published by Oxford University Press (OUP) in British Journal of Surgery
- Vol. 88 (1), 148-151
- https://doi.org/10.1046/j.1365-2168.2001.01630.x
Abstract
Background Postoperative adhesion formation has been associated with a reduced capacity to degrade fibrin within the peritoneal cavity. Peritoneal fibrinolytic capacity has been shown to decrease during the course of a surgical operation. The aim of this study was to investigate whether tissue-type plasminogen activator (tPA), a key fibrinolytic enzyme, is released into the peritoneal cavity during operation. Methods Fluid released from the serosal surface of the small bowel was collected in a plastic bag from 16 patients undergoing surgery. Intraoperative blood samples were also taken from seven patients. Concentrations of the fibrinolytic components tPA and urokinase plasminogen activator (uPA), tPA activity and plasminogen activator inhibitor type 1 (PAI-1) concentration were measured by enzyme-linked immunoabsorbent assay. Results Intraoperative tPA concentrations were significantly raised in the peritoneal fluid collected compared with peripheral blood levels (P = 0·008). This resulted in a significantly higher tPA activity in the fluid compared with blood (P = 0·001). However, neither uPA (P = 0·29) nor PAI-1 (P = 0·84) concentrations differed significantly in fluid compared with blood. Conclusion These data suggest that tPA is rapidly released by the visceral peritoneum during abdominal surgery. The different concentrations in peripheral blood and peritoneum suggest that tPA is released from the peritoneum by an active process, and does not solely derive from leakage of plasma. Presented in part to the International Congress on Peritoneal Repair and Adhesions (PAX, 5th meeting), Grantham, UK, October 1999, and to the XXXVth European Society for Surgical Research in Malmö, Sweden, June 2000Keywords
This publication has 17 references indexed in Scilit:
- Characterization and fibrinolytic properties of mesothelial cells isolated from peritoneal lavageScandinavian Journal of Clinical and Laboratory Investigation, 1998
- Intraperitoneal coagulation and fibrinolysis during inflammation: In vivo and in vitro observationsFibrinolysis, 1996
- Fibrinolysis in human peritoneum during operationSurgery, 1996
- Prevention of Tissue Injury and Postsurgical Adhesions by Precoating Tissues with Hyaluronic Acid SolutionsJournal of Surgical Research, 1995
- Human intraperitoneal fibrinolytic response to elective surgeryBritish Journal of Surgery, 1995
- Topics and Trends in Surgical Research: Evaluation of CMC and HA Solutions for AdhesiolysisJournal of Investigative Surgery, 1995
- Role of fibrinolysis in the formation of postoperative adhesionsWound Repair and Regeneration, 1994
- Prevention of Postoperative Abdominal Adhesions by Tissue Precoating with Polymer SolutionsJournal of Surgical Research, 1993
- Effect of Peritoneal Trauma on Peritoneal Fibrinolytic Activity and Intraperitoneal Adhesion FormationEuropean Surgical Research, 1981
- The aetiology of post-operative abdominal adhesions an experimental studyBritish Journal of Surgery, 1962