Postoperative Peritoneal Adhesion and Changes in Fibrinolytic Enzymes -With Special Reference to Postoperative Changes of Plasminogen Activator Activity in Supernatant of the Peritoneal Lavage Fluid-

Masaaki Kobayashi, Osamu Matsumoto, Jin-ichi Kameyama, Masaru Tsukamoto

First Department of Surgery, School of Medicine, Yamagata University

To study the mechanism of postoperative peritoneal adhesion, postoperative changes in fibrinolytic enzymes were measured using rats. After peritoneal adhesion operations, plasma tissue type plasminogen activator activities (t-PAA) (n=10), plasminogen activator inhibitor-1 activities (PAI-1A) (n=10), and t-PAA of supernatant of the peritoneal lavage fluid were measured (n=10). Plasma t-PAA was no remarkable change between preoperative and postoperative levels. Plasma PAI-IA was higher (N.S.) than the preoperative level at 72 and 168 hours. t-PAA of the supernatant of the peritoneal lavage fluid was significantly increased (p<0.01), showing peak levels by 24 hours. Then the levels gradually decreased and reached the preoperative level by 168 hours. After exploratory laparotomy, the t-PAA of the supernatant of the peritoneal lavage fluid in the serosal injury groups (n=6) was significantly lower (p<0.01) than in the control group at 6 hours. From these results, it was recommended that careful operation is important to prevent postoperative peritoneal adhesion.

Key words
postoperative changes in plasminogen activator activity, plasminogen activator activity in peritoneal lavage fluid, peritoneal adhesion

Reprint requests
Masaaki Kobayashi First Department of Surgery, Yamagata University School of Medicine
2-2-2 lida-Nishi, Yamagata, 990-23 JAPAN

Accepted
October 13, 1993

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