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Introduction: Insuflation abdominal cavity with carbon dioxide during laparoscopic surgery increases abdominal pressure, which may cause stasis of the blood flow in inferior vena cava and common iliac veins. Moreover, reverse Trendelenburg position, in which laparoscopic cholecystectomy is performed, decreases venous return. All of this factors makes episode of venous thromboembilism (VTE), an asymptomatic state that could cause serious complications, more probable., Aim: The aim of the study was to asses influence of pneumoperitoneum during laparoscopic procedures on coagulation state and to asses relation between body mass index (BMI), age of patients undergoing laparoscopic procedures and coagulation profile in the postoperative period., Material and Methods: The study enrolled 35 patients (F:M = 28:7, mean age 48.3 ± 14.6, mean BMI 26 ± 4.5 kg/m2), without VTE risk factors, not undergoing anticoagulant therapy and without abnormal platelet count. Subjects underwent laparoscopic cholecystectomy. Alteration in coagulation profile was assesed on the basis of aPTT, PT and TT results. Blood samples were taken twice: in the day of admission (samle A) and 5 hours after surgery (sample B). Statistical analysys was performed using Wilcoxon signed rank test and Spearman correlation., Results: Mean aPTT, PT and TT value of the A sample was 34.54 ± 6.32s, 1.11± 0.14 INR; 16.35 ± 1.93s respectively. Mean aPPT, PT and TT value of the B sample was 34.4 ± 7.13s; 1.17 ± 0.11 INR; 16.41 ± 1.88s, respectively. Change of PT value pre- and postoperatively was statistical significant (p = 0.0009). There was statistical significant correlation between duration of the surgery and sample B PT and TT values (p = 0.0115 and 0.0218 respectively). No other correlation between BMI, age and sample B values was observed., Conclusions: Creation of pneumoperitoneum has no influence on shortening of clotting times. Because of early mobilisation, fast discharge and recovery that makes natural anticoaculant prevention available short after surgery, clinical risk of DVT is not high.

Introduction: Venous thromboembolism (VTE) is one of the most dangerous complication that could occur in patiens treated in surgical ward. Threat is increased due to presence of additional, apart from surgical procedures, risk factors. It is assesed, that approximately 50 000 patients are at risk of VTE yearly in Poland, 20 000 of them develop pulmonary thromboembolism during hospitalisation, which is fatal in 10% of cases., Aim: Aim of the study was to asses presence of VTE risk factors in the group of patients treated in the 2nd Chair of Surgery Jagiellonian University Medical College and to analyse applied prophylaxis., Material and Methods: The study enrolled 170 patients, 89 (52%) females and 81 (48%) males. Average age of the studied group was 57.9. Medical history of all patients was taken with an emphasis on presence of VTE risk factors. It had a form of questionnaire and enclosed questions. Apart from the anamnesis, physical examination was performed. Type of applied prophylaxis was assesed on the basis of medical records., Results: Each patient was charged with 4 risk factors on average. The most common risk factors were: age, surgical procedure lasting longer than 45 minutes, ischaemic heart disease and hipertension. Clinical probability of deep venous thrombosis was assesed according to Wells scale; low: 59% of studied group, intermediate: 41%, high: 0%. Applied prophylaxis included pharmacotherapy, physiotherapy, and mechanical methods (compression)., Conclusions: The most common risk factor that could be changed was duration of the surgery lasting longer than 45 minutes. Pharmacological prophylaxis should be more often complemented by mechanical methods and physiotherapy, especially in group burdened with high risk of VTE.