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Tissue markers as predictors of postoperative adhesions
- Source :
- The British journal of surgery. 85(11)
- Publication Year :
- 1998
-
Abstract
- Background Postoperative adhesion formation has been associated with a decreased capacity to degrade intra-abdominally deposited fibrin. Adhesions, once lysed, have a high propensity for reformation. This study tested the hypothesis that patients with a high propensity for adhesion formation as well as adhesion tissue had a reduced fibrinolytic capacity. Methods Peritoneal biopsies were taken during abdominal surgery from 21 patients who had previously undergone operation; previously formed adhesion tissue was sampled from ten of these patients. Adhesion formation was scored. The fibrinolytic capacity of peritoneum was determined in tissue extracts. Results At the time of opening of the abdominal cavity, levels of plasminogen activator inhibitor (PAI) type 1 (P = 0·009) and tissue-type plasminogen activator (tPA)/PAI complex (P = 0·008) were increased in peritoneal samples from patients with severe adhesions compared with those in samples from patients with less severe adhesions. Adhesion tissue similarly had reduced fibrinolytic capacity as judged by a decrease in tPA activity (P = 0·005) and an increase in PAI-1 level (P = 0·01), reflected in an increased level of tPA/PAI complex (P = 0·008) compared with unaffected peritoneum. Conclusion These observations demonstrate reduced fibrinolytic capacity in peritoneal tissue in patients with a greater propensity for development of adhesions and likewise in adhesion tissue. This suggests that components of the fibrinolytic system may be used as markers of an increased risk of adhesion development.
- Subjects :
- Male
medicine.medical_specialty
Pathology
medicine.medical_treatment
Urology
Adhesion (medicine)
Tissue Adhesions
Abdominal cavity
Fibrin
Plasminogen Activators
Postoperative Complications
Peritoneum
Biopsy
Fibrinolysis
Plasminogen Activator Inhibitor 1
Medicine
Humans
medicine.diagnostic_test
biology
business.industry
medicine.disease
medicine.anatomical_structure
biology.protein
Surgery
Female
business
Plasminogen activator
Biomarkers
Abdominal surgery
Subjects
Details
- ISSN :
- 00071323
- Volume :
- 85
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- The British journal of surgery
- Accession number :
- edsair.doi.dedup.....0c4d90f0906a62678c609317ed5e8bfe