THE OPERATIVE PERITONEAL FIBRINOLYTIC RESPONSE TO ABDOMINAL OPERATION

Objective: To measure changes in the fibrinolytic properties of human peritoneum during operation. Design: Open study. Setting: University h ospital, UK. Subjects: 20 patients undergoing elective operations for non-inflammatory disease. Interventions: Peritoneum was biopsied at th e beginning and end of operation. Main outcome measures: Peritoneal pl asminogen activating activity (PAA) and the concentrations of tissue p lasminogen activator (t-PA), urokinase, and plasminogen activator inhi bitors 1 and 2 were measured at both time points. Results: Peritoneal PAA was reduced over the time of the operation (p < 0.05) as was the c oncentration. of t-PA (p < 0.05). The urokinase concentration rose sig nificantly (p < 0.05). bur plasminogen activator inhibitors 1 and 2 we re not detected. Conclusions: Elective abdominal operation caused an i mmediate reduction in peritoneal PAA which seemed to be secondary to a reduced concentration of t-PA. Such a reduction in peritoneal fibrino lytic activity allows the early deposition of fibrinous deposits withi n the peritoneal cavity.