The dynamics and clinical significance of alpha 2 plasmin inhibitor-plasmin complex and thrombin-antithrombin complex in postoperative pleural effusion following a pulmonary lobectomy

Fumihiro Shoji, Tokujiro Yano, Ichiro Yoshino, Daigo Kawano, Tomoyoshi Takenaka, Naoko Miura, Kensaku Ito, Yosuke Morodomi, Yoshihiko Maehara

Research output: Contribution to journalArticle

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Abstract

Purpose: The overall incidence of postoperative alveolar air leakage (AAL) remains high; however, the mechanism regarding how to adequately heal such postoperative AAL remains to be elucidated. The aim of this study was to determine any correlations between the activity of the fibrinolytic and coagulation system in the postoperative pleural effusion and appearance or disappearance of postoperative AAL. Methods: This study prospectively investigated 25 patients who underwent a pulmonary lobectomy from July 2005 to March 2006. Pleural effusion was collected through the chest tube. Alpha 2 plasmin inhibitor-plasmin complex (PIC), as a fibrinolytic marker, and thrombin-antithrombin complex (TAT), as a coagulation marker, were measured. Results: The activity of the coagulation system was higher than that of the fibrinolytic system. The concentration of TAT tended to increase (3rd vs 4th postoperative day [POD], P = 0.0907). The mean time of appearance and disappearance of postoperative AAL was 1.4 days and 3.2 days, respectively. The patients with postoperative AAL had a TAT level significantly below the average on the 3rd POD in comparison to the patients without postoperative AAL (P = 0.0163). Moreover, the concentration of TAT in patients with postoperative AAL was significantly lower than that in patients without postoperative AAL (1824.0 ± 137.3 ng/ml vs 3444.0 ± 287.6 ng/ml, P = 0.0113) on the 3rd POD. On the 4th POD, the concentration of TAT was almost same and there was no significance (P = 0.6759). Conclusions: This study demonstrated for the first time the course of the fibrinolytic and coagulation activity in the pleural effusion after a pulmonary lobectomy, and showed that the delayed activity of the coagulation system is associated with the appearance of the postoperative AAL.

Original languageEnglish
Pages (from-to)320-325
Number of pages6
JournalSurgery today
Volume39
Issue number4
DOIs
Publication statusPublished - Apr 1 2009

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Pleural Effusion
Air
Lung
antithrombin III-protease complex
plasmin-plasmin inhibitor complex
Chest Tubes
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery

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The dynamics and clinical significance of alpha 2 plasmin inhibitor-plasmin complex and thrombin-antithrombin complex in postoperative pleural effusion following a pulmonary lobectomy. / Shoji, Fumihiro; Yano, Tokujiro; Yoshino, Ichiro; Kawano, Daigo; Takenaka, Tomoyoshi; Miura, Naoko; Ito, Kensaku; Morodomi, Yosuke; Maehara, Yoshihiko.

In: Surgery today, Vol. 39, No. 4, 01.04.2009, p. 320-325.

Research output: Contribution to journalArticle

Shoji, Fumihiro ; Yano, Tokujiro ; Yoshino, Ichiro ; Kawano, Daigo ; Takenaka, Tomoyoshi ; Miura, Naoko ; Ito, Kensaku ; Morodomi, Yosuke ; Maehara, Yoshihiko. / The dynamics and clinical significance of alpha 2 plasmin inhibitor-plasmin complex and thrombin-antithrombin complex in postoperative pleural effusion following a pulmonary lobectomy. In: Surgery today. 2009 ; Vol. 39, No. 4. pp. 320-325.
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abstract = "Purpose: The overall incidence of postoperative alveolar air leakage (AAL) remains high; however, the mechanism regarding how to adequately heal such postoperative AAL remains to be elucidated. The aim of this study was to determine any correlations between the activity of the fibrinolytic and coagulation system in the postoperative pleural effusion and appearance or disappearance of postoperative AAL. Methods: This study prospectively investigated 25 patients who underwent a pulmonary lobectomy from July 2005 to March 2006. Pleural effusion was collected through the chest tube. Alpha 2 plasmin inhibitor-plasmin complex (PIC), as a fibrinolytic marker, and thrombin-antithrombin complex (TAT), as a coagulation marker, were measured. Results: The activity of the coagulation system was higher than that of the fibrinolytic system. The concentration of TAT tended to increase (3rd vs 4th postoperative day [POD], P = 0.0907). The mean time of appearance and disappearance of postoperative AAL was 1.4 days and 3.2 days, respectively. The patients with postoperative AAL had a TAT level significantly below the average on the 3rd POD in comparison to the patients without postoperative AAL (P = 0.0163). Moreover, the concentration of TAT in patients with postoperative AAL was significantly lower than that in patients without postoperative AAL (1824.0 ± 137.3 ng/ml vs 3444.0 ± 287.6 ng/ml, P = 0.0113) on the 3rd POD. On the 4th POD, the concentration of TAT was almost same and there was no significance (P = 0.6759). Conclusions: This study demonstrated for the first time the course of the fibrinolytic and coagulation activity in the pleural effusion after a pulmonary lobectomy, and showed that the delayed activity of the coagulation system is associated with the appearance of the postoperative AAL.",
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T1 - The dynamics and clinical significance of alpha 2 plasmin inhibitor-plasmin complex and thrombin-antithrombin complex in postoperative pleural effusion following a pulmonary lobectomy

AU - Shoji, Fumihiro

AU - Yano, Tokujiro

AU - Yoshino, Ichiro

AU - Kawano, Daigo

AU - Takenaka, Tomoyoshi

AU - Miura, Naoko

AU - Ito, Kensaku

AU - Morodomi, Yosuke

AU - Maehara, Yoshihiko

PY - 2009/4/1

Y1 - 2009/4/1

N2 - Purpose: The overall incidence of postoperative alveolar air leakage (AAL) remains high; however, the mechanism regarding how to adequately heal such postoperative AAL remains to be elucidated. The aim of this study was to determine any correlations between the activity of the fibrinolytic and coagulation system in the postoperative pleural effusion and appearance or disappearance of postoperative AAL. Methods: This study prospectively investigated 25 patients who underwent a pulmonary lobectomy from July 2005 to March 2006. Pleural effusion was collected through the chest tube. Alpha 2 plasmin inhibitor-plasmin complex (PIC), as a fibrinolytic marker, and thrombin-antithrombin complex (TAT), as a coagulation marker, were measured. Results: The activity of the coagulation system was higher than that of the fibrinolytic system. The concentration of TAT tended to increase (3rd vs 4th postoperative day [POD], P = 0.0907). The mean time of appearance and disappearance of postoperative AAL was 1.4 days and 3.2 days, respectively. The patients with postoperative AAL had a TAT level significantly below the average on the 3rd POD in comparison to the patients without postoperative AAL (P = 0.0163). Moreover, the concentration of TAT in patients with postoperative AAL was significantly lower than that in patients without postoperative AAL (1824.0 ± 137.3 ng/ml vs 3444.0 ± 287.6 ng/ml, P = 0.0113) on the 3rd POD. On the 4th POD, the concentration of TAT was almost same and there was no significance (P = 0.6759). Conclusions: This study demonstrated for the first time the course of the fibrinolytic and coagulation activity in the pleural effusion after a pulmonary lobectomy, and showed that the delayed activity of the coagulation system is associated with the appearance of the postoperative AAL.

AB - Purpose: The overall incidence of postoperative alveolar air leakage (AAL) remains high; however, the mechanism regarding how to adequately heal such postoperative AAL remains to be elucidated. The aim of this study was to determine any correlations between the activity of the fibrinolytic and coagulation system in the postoperative pleural effusion and appearance or disappearance of postoperative AAL. Methods: This study prospectively investigated 25 patients who underwent a pulmonary lobectomy from July 2005 to March 2006. Pleural effusion was collected through the chest tube. Alpha 2 plasmin inhibitor-plasmin complex (PIC), as a fibrinolytic marker, and thrombin-antithrombin complex (TAT), as a coagulation marker, were measured. Results: The activity of the coagulation system was higher than that of the fibrinolytic system. The concentration of TAT tended to increase (3rd vs 4th postoperative day [POD], P = 0.0907). The mean time of appearance and disappearance of postoperative AAL was 1.4 days and 3.2 days, respectively. The patients with postoperative AAL had a TAT level significantly below the average on the 3rd POD in comparison to the patients without postoperative AAL (P = 0.0163). Moreover, the concentration of TAT in patients with postoperative AAL was significantly lower than that in patients without postoperative AAL (1824.0 ± 137.3 ng/ml vs 3444.0 ± 287.6 ng/ml, P = 0.0113) on the 3rd POD. On the 4th POD, the concentration of TAT was almost same and there was no significance (P = 0.6759). Conclusions: This study demonstrated for the first time the course of the fibrinolytic and coagulation activity in the pleural effusion after a pulmonary lobectomy, and showed that the delayed activity of the coagulation system is associated with the appearance of the postoperative AAL.

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