This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Time course of peritoneal tissue plasminogen activator after experimental colonic surgery: effect of hyaluronan‐based antiadhesive agents and bacterial peritonitis. BJS 2002; 89: 103-109.
Published: 5th November 2002
Authors: M. M. P. J. Reijnen, L. Holmdahl, T. Kooistra, P. Falk, T. Hendriks, H. van Goor et al.
Background
This study assessed the peritoneal fibrinolytic response during the first week after colonic surgery in rats with and without bacterial peritonitis, and possible modulation of the response by two hyaluronan‐based antiadhesive agents.
Method
A colonic anastomosis was constructed in 90 male Wistar rats. Peritonitis was induced in another 108 rats and a colonic anastomosis was constructed after 24 h. Rats in both groups were randomized into an untreated group or one of two groups treated with hyaluronan‐based agents. One‐third of each group was killed at each of days 1, 3 and 7 after operation, and tissue plasminogen activator (tPA) antigen and activity were measured in peritoneal biopsies.
Results
One day after colonic surgery in normal rats, tPA antigen concentration was significantly (P < 0·005) increased, whereas tPA activity levels were normal. By day 3 after operation tPA antigen had returned to baseline values while tPA activity was significantly increased (P < 0·05). One day after inducing peritonitis tPA antigen was significantly increased (P < 0·001), while tPA activity was significantly reduced (P < 0·05). Three and seven days after colonic surgery in rats with peritonitis tPA activity was increased (P < 0·001) while tPA antigen had returned to baseline values. Neither of the hyaluronan‐based agents affected peritoneal tPA antigen levels or activity after colonic surgery.
Conclusion
Both abdominal surgery and infection caused an early increase in peritoneal tPA antigen levels, followed by an increase in tPA activity. Peritonitis severely depressed early tPA activity. Application of hyaluronan‐based agents did not affect the peritoneal fibrinolytic response to surgery and/or infection. © 2002 British Journal of Surgery Society Ltd
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