CHANGES IN FIBRINOGEN LEVELS IN PATIENTS UNDERGOING OPEN AND LAPAROSCOPIC NISSEN FUNDOPLICATION

Background: Venous thromboembolic complications may be more common aft er laparoscopic surgical techniques, possibly due to changes in venous now and blood coagulability. Methods: This study assessed fibrinogen, cross-linked fibrin degradation products (D-dimer), prothrombin inter national normalized ratio (INR), activated partial thromboplastin time (APTT) and platelets, during and after both open and laparoscopic Nis sen fundoplication to determine whether coagulability is increased by the laparoscopic approach. Results: Seven patients underwent open and thirteen underwent laparoscopic Nissen fundoplication. Fibrinogen leve ls following open fundoplication fell from 7.8 +/- 0.3 g/L pre-operati vely to 2.0 +/- 0.3 g/L following shin incision, and then increased to 4.1 +/- 0.4 on the first postoperative day. Similar changes in fibrin ogen occurred following laparoscopic fundoplication (2.7 +/- 0.2, 2.5 +/- 0.3 and 3.8 +/- 0.4 g/L, respectively). No significant changes in the other coagulation indices were observed. Conclusions: These result s demonstrate hypercoagulabilty on first postoperative day, irrespecti ve of the operative technique. No differences between the results foll owing laparoscopic and open fundoplication were demonstrated.