Differences in perioperative coagulation between Japanese and other ethnic groups undergoing laparoscopic cholecystectomy.
BACKGROUND
Japanese patients experience fewer episodes of postoperative thrombosis than those in certain other countries. To investigate this phenomenon, we measured perioperative coagulation activation markers and conducted thromboelastography (TEG) in 27 Japanese patients undergoing laparoscopic cholecystectomy.


METHODS
D-dimer, thrombin-antithrombin complex (TAT), and prothrombin fragment 1+2 (F1+2) were measured as coagulation activation markers. TEG was performed to measure reaction time (R), clot formation time (K), maximum amplitude (MA), and maximum elastance (ME). These measurements were performed before and after the operation and the day after the operation.


RESULTS
Coagulation activation markers increased significantly postoperatively. With respect to TEG, MA and ME increased postoperatively. R and K did not change.


CONCLUSIONS
Whereas clotting factor activation sthenia is common in Europe and North America, thrombocyte function sthenia occurs in Japanese patients. This difference may account for the differing incidences of phlebothrombosis in Japanese and white populations.
Iwade
M
M
Department of Anesthesiology, Tokyo Women's Medical University, School of Medicine, 162-8666, 8-1, Kawatacho Shinjukuku, Tokyo, Japan. kmsti@pf6.so-net.ne.jp
Iwade
K
K
Nomura
M
M
Ozaki
M
M
D000368:Aged; D000990:Antithrombin III / Q000032:analysis; D015415:Biomarkers; D001777:Blood Coagulation; D001780:Blood Coagulation Tests; D017081:Cholecystectomy, Laparoscopic; D004198:Disease Susceptibility; D005006:Ethnicity; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000032:analysis; D010447:Peptide Hydrolases / Q000032:analysis; D010976:Platelet Count; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D011300:Preoperative Care; D011516:Prothrombin / Q000032:analysis; D013916:Thrombelastography; D019851:Thrombophilia / Q000097:blood / Q000208:ethnology*; D013924:Thrombophlebitis / Q000208:ethnology; D013927:Thrombosis / Q000208:ethnology
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D010446:Peptide Fragments; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; C045879:prothrombin fragment 1.2; D000990:Antithrombin III; D011516:Prothrombin; D010447:Peptide Hydrolases