J.Jpn. Surg. Soc.. 90(2): 199-209, 1989

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Original article

INFLUENCE OF THORACOTOMY AND PULMOANRY SURGERY ON COAGULATIN AND FIBRINOLYSIS IN THE INTRA AND POSTOPERATIVE PERIOD
ーEXPERIMENTAL AND CLINICAL STUDYー

Changes in intraoperative coagulation and fibrinolysis during pulmoanry surgery were studied using mongrel dogs. Twently dogs were divided into two groups；dogs in group I (N＝10) received physical manipulation,“massage”of the left lung under thoracotomy, while dogs in group II (N＝10) underwent thoracotomy with no mechanical manipulation. In comparison with group II, subjects in group I showed significant decrease antithrombin III (ATIII) and α₂-plasmin inhibitor (α₂-PI) in blood of the pulmanry vein, pulmoanry artery and peripheral vein for four hours after the initiation of the experiment. This finding suggested that both coagulatin and fibrinolytic activity increased in lung tissue and circulating blood thoracotomy and pulmoanry manipulaton for more than four hours.
Changes in postoperative coagulation and fibrinolysis were studied in 57 patients in whom pulmoanry surgical procedures (pneumonectomy in 4 cases, lobectomy in 27, partial resection in 7, bullectomy in 16 and exploratory thoracotomy in 3 cases) were performed at Toho University Hospital from January, 1986 to June,1987. Both protein C and ATIII, which are coagulatin inhibiting factors, showed the lowest levels from the first to third postoperative day which suggested that coaguation activity was accelerated in that period, with a return to preoperative values being observed on the seventh postoperative day.

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