cardiothoracic surgery, the “da Vinci” robot found popularity within the urological community and it is now used for robot assisted laoaroscopic prostatectomy (RALP) [Abbou et al., 2001]. In the last period, some investigations suggested that a number of factors in the perioperative period could promote metastasization. These include the surgery approach and its associated stress response, the anaesthetic regimen, the acute pain, and the administration of opioid analgesics [Mao et al., 2013]. The hypothesis, in fact, is that different anesthetic protocols and surgery techniques can differently activate the clotting system, or stimulate mononuclear cells, platelets and endothelial cells. The consequent formation of a fibrin matrix, together with cell activation, appear to promote tumor growth and neo- angiogenic processes [Falanga et al., 2013]. Part of this thesis is therefore dedicated to describe the effects on coagulation and platelet-activation markers of two established types of anaesthesia in 102 patients with primary PCa undergoing LRP or RALP. In particular, before the induction of anaesthesia (T0), 1 hr post-surgery (T1) and 24 hrs post-surgery (T2) plasma levels of fibrinogen, thrombin-antithrombin complex (TAT), prothrombin fragment 1+2 (PF12), factor VIII (FVIII), plasminogen- activator inhibitor (PAI-1), D-dimer (DD), p-selectin, anti-thrombin (AT), protein C (PC) and protein S (PS) were evaluated. In this light, perioperative variations of these parameters were followed in order to highlight the pro-thrombotic properties of different anesthetic protocols and surgery techniques during the treatment of PCa patients, trying to assess which manipulation could higher the risk of further complications.
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