Preoperative predictors of postsurgical adhesion formation and the Prevention of Adhesions with Plasminogen Activator (PAPA-study): results of a clinical.

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Preoperative predictors of postsurgical adhesion formation and the Prevention of Adhesions with Plasminogen Activator (PAPA-study): results of a clinical pilot study Bart W.J. Hellebrekers, M.D., Ph.D., Trudy C.M. Trimbos-Kemper, M.D., Ph.D., Lianne Boesten, Ph.D., Frank Willem Jansen, M.D., Ph.D., Wendela Kolkman, M.D., Ph.D., J. Baptist Trimbos, M.D., Ph.D., Rogier R. Press, Pharm.D., Mariette I.E. van Poelgeest, M.D., Ph.D., Sjef J. Emeis, Ph.D., Teake Kooistra, Ph.D. Fertility and Sterility Volume 91, Issue 4, Pages 1204-1214 (April 2009) DOI: 10.1016/j.fertnstert.2008.01.052 Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions

Figure 1 Mean preoperative plasma levels of CRP in patients with and without adhesions (yes vs. no) at early second-look laparoscopy (ESL). Mann-Whitney U test: rs = 0.471; P=.027; n = 23). Fertility and Sterility 2009 91, 1204-1214DOI: (10.1016/j.fertnstert.2008.01.052) Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions

Figure 2 Correlation between the change in tissue-type plasminogen activator (tPA) concentration (ΔtPA) in peritoneal fluid from initial surgery to early second-look laparoscopy (ESL) and extent of adhesion formation (cm2) confined to the uterus at ESL (Spearman rho: rs = −0.636; P=.001; n = 22). Fertility and Sterility 2009 91, 1204-1214DOI: (10.1016/j.fertnstert.2008.01.052) Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions

Figure 3 Mean change in tissue-type plasminogen activator (tPA) concentration (ΔtPA) in peritoneal fluid from initial surgery to ESL in patients with and without adhesions (yes vs. no) at early second-look laparoscopy (ESL). (Mann-Whitney U test: rs = −0.561; P=.01; n = 22). Fertility and Sterility 2009 91, 1204-1214DOI: (10.1016/j.fertnstert.2008.01.052) Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions

Figure 4 Postoperative course of concentrations in plasma of fibrinolytic parameters and C-reactive protein (CRP) after myomectomy (values are median). ∗time points that were significantly different from baseline values (P<.05, analysis of variance for repeated measures). Fertility and Sterility 2009 91, 1204-1214DOI: (10.1016/j.fertnstert.2008.01.052) Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions