Hysterectomy techniques and their effect on the blood markers of thrombogenicity

• Published in: Gynaecological endoscopy Vol. 9; no. 6; pp. 379 - 383
• Main Authors: Singer, Iain O., Pringle, Stewart, Tait, R. Campbell, Moore, Karen, Alexander, Claire, Hawthorn, Robert
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.12.2000
• Subjects: activation markers; coagulation; hysterectomy techniques; surgical risk; thromboprophylaxis; thrombosis
• ISSN: 0962-1091; 1365-2508
• DOI: 10.1046/j.1365-2508.2000.00383.x

Objective The use of laparoscopic surgery appears to reduce patient trauma and permits earlier discharge. However, the operation may be longer and the overall effect on coagulation and the risk of thrombosis is not clear. Design We compared the effect on coagulation activation markers (thrombin–antithrombin, prothrombin fragments 1+2 and d‐dimers) and factors (protein C, antithrombin, fibrinogen and activated protein C resistance) of laparoscopic and open abdominal hysterectomy in 39 women for the week following surgery. Some of these are well‐recognised markers of thrombotic risk. Results We found no evidence to suggest that laparoscopic hysterectomy has a more favourable prothrombotic profile. There were no major differences between the surgical options. Conclusions Laparoscopic hysterectomy should be subject to the same rigour of thromboprophylaxis as open abdominal hysterectomy. We did find evidence of a prolonged prothrombotic state beyond the normal period of thromboprophylaxis in both groups.