[Influence of thoracotomy and pulmonary surgery on coagulation and fibrinolysis in the intra and postoperative period--experimental and clinical study].
Changes in intraoperative coagulation and fibrinolysis during pulmonary surgery were studied using mongrel dogs. Twenty dogs were divided into two groups; dogs in group I (N = 10) received physical manipulation, "massage" of the left lung under thoracotomy, while dogs in group II (N = 10) underwent thoracotomy with no mechanical manipulation. In comparison with group II, subjects in group I showed significant decrease antithrombin III (ATIII) and alpha 2-plasmin inhibitor (alpha 2-PI) in blood of the pulmonary vein, pulmonary artery and peripheral vein for four hours after the initiation of the experiment. This finding suggested that both coagulation and fibrinolytic activity increased in lung tissue and circulating blood thoracotomy and pulmonary manipulation for more than four hours. Changes in postoperative coagulation and fibrinolysis were studied in 57 patients in whom pulmonary surgical procedures (pneumonectomy in 4 cases, lobectomy in 27, partial resection in 7, bullectomy in 16 and exploratory thoracotomy in 3 cases) were performed at Toho University Hospital from January, 1986 to June, 1987. Both protein C and ATIII, which are coagulation inhibiting factors, showed the lowest levels from the first to third postoperative day which suggested that coagulation activity was accelerated in that period, with a return to preoperative values being observed on the seventh postoperative day.
Sembo
J
J
Department of Thoracic and Cardovascular Surgery, Toho University School of Medicine, Japan.
D000818:Animals; D000990:Antithrombin III / Q000378:metabolism; D001777:Blood Coagulation; D004285:Dogs; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D005342:Fibrinolysis; D006801:Humans; D007432:Intraoperative Period; D008168:Lung / Q000378:metabolism / Q000601:surgery*; D008405:Massage; D010958:Plasminogen / Q000378:metabolism; D010976:Platelet Count; D011184:Postoperative Period; D011486:Protein C / Q000378:metabolism; D013908:Thoracotomy; D000979:alpha-2-Antiplasmin / Q000378:metabolism
D005338:Fibrin Fibrinogen Degradation Products; D011486:Protein C; D000979:alpha-2-Antiplasmin; D000990:Antithrombin III; D005340:Fibrinogen; D010958:Plasminogen