title: The effect of pneumoperitoneum on intravascular fibrinolytic activity in rats.
abstract: OBJECTIVE
  Venous stasis during pneumoperitoneum in laparoscopic surgery is closely related to fibrin synthesis and deposition. The etiologic factors underlying fibrinolysis or hypercoagulability are not clearly defined. This study aimed to determine the effects of pneumoperitoneum time and pressure on coagulation cascade and the fibrinolytic pathway.
  
  
  METHODS
  After the pneumoperitoneum model was established in rats, PAI-1, tPA, TAFI, D-dimer, and fibrinogen activities were evaluated in different time periods under different pressures in groups including 6 rats. Group 1 did not undergo any procedure. Group 2 received 8 mmHg of pressure for 30 min, Group III 8 mmHg for 60 min, Group IV 12 mmHg for 30 min, and Group V 12 mmHg for 60 min.
  
  
  RESULTS
  D-dimer levels had a tendency to decrease with increasing intraabdominal pressures. In both low and high pressure groups, fibrinogen had a tendency to increase with exposure time. There was no statistically significant difference among the study groups in terms of fibrinogen, D-dimer, and PAI-1. The levels of TAFI were significantly decreased with increasing pressure regardless of the exposure time.
  
  
  CONCLUSIONS
  Pneumoperitoneum of the coagulation system can be changed by duration of time and pressure.
authors.affiliation: Department of General Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Kürşat
authors.initials: K
authors.lastname: Dikmen
authors.affiliation: Department of Public Health, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Asiye
authors.initials: A
authors.lastname: Uğraş Dikmen
authors.affiliation: Department of General Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Bostancı
authors.affiliation: Department of General Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Karamercan
authors.affiliation: Department of Hematology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Münci
authors.initials: M
authors.lastname: Yağcı
authors.affiliation: Department of General Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Akın
authors.affiliation: Department of General Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Bülent
authors.initials: B
authors.lastname: Aytaç
mesh_terms: D000818:Animals; D001777:Blood Coagulation; D005342:Fibrinolysis; D007274:Injections, Intraperitoneal; D010535:Laparoscopy; D011027:Pneumoperitoneum; D051381:Rats
keywords: Pneumoperitoneum; fibrinolysis; hypercoagulability