title: [Coagulation profile in patients undergoing elective laparoscopic surgery].
abstract: BACKGROUND
  Insuflation abdominal cavity with carbon dioxide during laparoscopic surgery increases abdominal pressure, which may cause stasis of the blood flow in inferior vena cava and common iliac veins. Moreover, reverse Trendelenburg position, in which laparoscopic cholecystectomy is performed, decreases venous return. All of this factors makes episode of venous thromboembilism (VTE), an asymptomatic state that could cause serious complications, more probable.
  
  
  OBJECTIVE
  The aim of the study was to asses influence of pneumoperitoneum during laparoscopic procedures on coagulation state and to asses relation between body mass index (BMI), age of patients undergoing laparoscopic procedures and coagulation profile in the postoperative period.
  
  
  METHODS
  The study enrolled 35 patients (F:M = 28:7, mean age 48.3 ± 14.6, mean BMI 26 ± 4.5 kg/m2), without VTE risk factors, not undergoing anticoagulant therapy and without abnormal platelet count. Subjects underwent laparoscopic cholecystectomy. Alteration in coagulation profile was assesed on the basis of aPTT, PT and TT results. Blood samples were taken twice: in the day of admission (samle A) and 5 hours after surgery (sample B). Statistical analysys was performed using Wilcoxon signed rank test and Spearman correlation.
  
  
  RESULTS
  Mean aPTT, PT and TT value of the A sample was 34.54 ± 6.32s, 1.11± 0.14 INR; 16.35 ± 1.93s respectively. Mean aPPT, PT and TT value of the B sample was 34.4 ± 7.13s; 1.17 ± 0.11 INR; 16.41 ± 1.88s, respectively. Change of PT value pre- and postoperatively was statistical significant (p = 0.0009). There was statistical significant correlation between duration of the surgery and sample B PT and TT values (p = 0.0115 and 0.0218 respectively). No other correlation between BMI, age and sample B values was observed.
  
  
  CONCLUSIONS
  Creation of pneumoperitoneum has no influence on shortening of clotting times. Because of early mobilisation, fast discharge and recovery that makes natural anticoaculant prevention available short after surgery, clinical risk of DVT is not high.
authors.forename: Michał
authors.initials: M
authors.lastname: Natkaniec
authors.forename: Kamil
authors.initials: K
authors.lastname: Szczupak
authors.forename: Mateusz
authors.initials: M
authors.lastname: Ostachowski
authors.forename: Maciej
authors.initials: M
authors.lastname: Matłok
authors.forename: Marcin
authors.initials: M
authors.lastname: Migaczewski
authors.forename: Michal
authors.initials: M
authors.lastname: Pędziwiatr
mesh_terms: D000328:Adult; D000368:Aged; D001777:Blood Coagulation; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D004434:Early Ambulation; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D005260:Female; D018475:Head-Down Tilt / Q000009:adverse effects; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D010976:Platelet Count; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D055815:Young Adult