Farklı basınç ve sürelerde uygulanan karbondioksit insuflasyonunun trombotik faktörler üzerine etkisi

It ıs a known fact for a long time that, trauma which is caused by open surgical procedures, is a predisposing factor for thrombotic events.. In laparoscopic surgery, which is known to cause less tissue trauma, encountering with lower tromboembolic complicaitons is an expected situation. However, recently, the increase in the incidence of venous thromboembolism after widespread use of laparoscopy in surgical procedures have led the researchers to find the cause. The increase in the intraabdominal pressure caused by pneumoperitoneum; results in a reduced flow of vena cava inferior and lower extremities venous return and an increase in venous blood pleasure. At the same time reduced splanchnic circulation improves after desufflatıon and the reperfusion injury which occurs in vascular endothelium is the intiation of the formation of the thrombus . The aim of this experimantal study which is applied on rats, is to determine the differences on the clottıng factors over the application of low and hıgh intraabdominal pressure values in different periods of time. In our experiment, there were 5 groups, each consisting of 6 rats; a control group (Group K) and 1 hour 6mm Hg (Group A), 2 h 6mm Hg (Group B), 1 hour 12mm Hg (Group C), 2 hours and 12 mm Hg (Group D). At the end of the experiment, plasma samples taken from subjects and fibrinogen, FII (prothrombin), FV, FVII, FVIII, FIX, FX, FXI, FXII, vWF, ristocetin cofactor, protein C, protein S, ATIII levels are studied. There were statistically significant differences in the mean levels of FII, FV, FVII, FVIII, FIX, FX, FXI, FXII, and protein S between the groups. As a result, the increase in IAP created by CO2 insufflation causes physical and chemical hemodynamic changes which activate mechanisms of coagulation and potentiate thrombosis.