Changes in fibrinogen levels in patients undergoing open and laparoscopic Nissen fundoplication

The Australian and New Zealand Journal of Surgery
G K PikeG G Jamieson

Abstract

Venous thromboembolic complications may be more common after laparoscopic surgical techniques, possibly due to changes in venous flow and blood coagulability. This study assessed fibrinogen, cross-linked fibrin degradation products (D-dimer), prothrombin international normalized ration (INR), activated partial thromboplastic time (APTT) and platelets, during and after both open and laparoscopic Nissen fundoplication to determine whether coagulability is increased by the laparoscopic approach. Seven patients underwent open and thirteen underwent laparoscopic Nissen fundoplication. Fibrinogen levels following open fundoplication fell from 2.8 +/- 0.3 g/L pre-operatively to 2.0 +/- 0.3 g/L following skin incision, and then increased to 4.1 +/- 0.4 g/L on the first postoperative day. Similar changes in fibrinogen occurred following laparoscopic fundoplication (2.7 +/- 0.2, 2.5 +/ 0.2 and 3.8 +/- 0.4 g/L, respectively). No significant changes in the other coagulation indices were observed. These results demonstrate hypercoagulability on the first postoperative day, irrespective of the operative technique. No differences between the results following laparoscopic and open fundoplication were demonstrated.

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Citations

Jun 8, 2001·Surgical Endoscopy·D I Watson, A C de Beaux
Sep 30, 1998·The British Journal of Surgery·D I Watson, G G Jamieson
Oct 2, 2001·The British Journal of Surgery·A Gupta, D I Watson
Jan 23, 1999·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·C Martinez-RamosS Tamames-Escobar
Jun 26, 2009·Behavioral Ecology and Sociobiology·Fumihito Shibata, Takeo Kawamichi
Oct 31, 2014·World Journal of Gastroenterology : WJG·Richard HummelDamian J Hussey

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