BACKGROUND<\/p>\n
Our objective was to evaluate the impact of intraperitoneal pressure (IPP) and duration of a CO2<\/SUB> pneumoperitoneum on the peritoneal fibrinolytic system during laparoscopic surgery.<\/p>\n METHODS<\/p>\n Human study:<\/I> Patients undergoing laparoscopic surgery were divided into two groups: low (8 mmHg, n<\/I>= 32) or standard (12 mmHg, n<\/I>= 36) IPP. Normal peritoneum was collected from the parietal wall at the beginning of surgery and every 60 min thereafter. Mouse study:<\/I> Mice were divided into three groups: low (2 mmHg) or high (8 mmHg) IPP or laparotomy. Peritoneal tissue was collected at 0, 4, 8, 24, 48 and 72 h, and 5 and 7 days after surgery. Real-time RT–PCR was performed in humans and mice to measure the levels of tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) mRNA in peritoneal tissues.<\/p>\n RESULTS<\/p>\n Human study:<\/I> The tPA\/PAI-1 mRNA ratio was significantly decreased in the 12 mmHg group at 1 h [P<\/I>< 0.0001 versus matched initial peritoneal biopsies (MI)]. The tPA\/PAI-1 mRNA ratio decreased in both groups at 2 h (P<\/I>< .0.01 versus MI). Mouse study:<\/I> The tPA\/PAI-1 ratio was decreased at 0 h, and the difference was significant at 4 h in both the laparotomy (P<\/I>< 0.001 versus controls, 0 h, 5 and 7 days) and high-IPP (P<\/I>< 0.0001 versus 0, 48 and 72 h, 5 and 7 days) groups. No changes in tPA\/PAI-1 ratio were observed in the low-IPP group.<\/p>\n CONCLUSIONS<\/p>\n A low IPP and shorter duration of surgery appear to minimally impact the fibrinolytic system during a CO2<\/SUB> pneumoperitoneum.<\/p>\n","protected":false},"excerpt":{"rendered":" BACKGROUND Our objective was to evaluate the impact of intraperitoneal pressure (IPP) and duration of a CO2 pneumoperitoneum on the peritoneal fibrinolytic system during laparoscopic surgery. METHODS Human study: Patients undergoing laparoscopic surgery were divided into two groups: low (8 … Continue reading