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 hospital, UK. SUBJECTS: 20 patients undergoing elective operations for non-inflammatory disease. INTERVENTIONS: Peritoneum was biopsied at the beginning and end of operation. MAIN OUTCOME MEASURES: Peritoneal plasminogen activating activity (PAA) and the concentrations of tissue plasminogen activator (t-PA), urokinase, and plasminogen activator inhibitors 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 concentration of t-PA (p < 0.05). The urokinase concentration rose significantly (p < 0.05), but plasminogen activator inhibitors 1 and 2 were not detected. CONCLUSIONS: Elective abdominal operation caused an immediate reduction in peritoneal PAA which seemed to be secondary to a reduced concentration of t-PA. Such a reduction in peritoneal fibrinolytic activity allows the early deposition of fibrinous deposits within the peritoneal cavity.