Metabolic and inflammatory responses after laparoscopic and abdominal hysterectomy

OBJECTIVE: Our purpose was to quantify and compare the metabolic and inflammatory changes after laparoscopic and abdominal hysterectomy. STUDY DESIGN: Forty-four patients with no major medical disease requiring abdominal hysterectomy for benign disorders were randomly assigned to have laparoscopic h...

Full description

Saved in:
Bibliographic Details
Published in:American journal of obstetrics and gynecology 1998-07, Vol.179 (1), p.1-5
Main Authors: Yuen, Pong Mo, Mak, Tony W.L., Yim, So Fan, Ngan Kee, Warwick D., Lam, Christopher W.K., Rogers, Michael S., Chang, Allan M.Z.
Format: Article
Language:English
Subjects:
Abdomen - surgery
Adult
Area Under Curve
Biological and medical sciences
Biomarkers - blood
Biomarkers - urine
Female
Humans
Hysterectomy
Hysterectomy - adverse effects
Hysterectomy - methods
Inflammation - etiology
Inflammation - metabolism
inflammatory
laparoscopy
Laparoscopy - adverse effects
laparotomy
Medical sciences
metabolic
Middle Aged
Postoperative Complications
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the genital tract and mammary gland
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:OBJECTIVE: Our purpose was to quantify and compare the metabolic and inflammatory changes after laparoscopic and abdominal hysterectomy. STUDY DESIGN: Forty-four patients with no major medical disease requiring abdominal hysterectomy for benign disorders were randomly assigned to have laparoscopic hysterectomy ( n = 20) and abdominal hysterectomy ( n = 24). Venous blood and 24-hour urine samples were collected the day before and for each of the first 3 postoperative days. RESULTS: No differences were present in demographic characteristics, operating time, and uterine weight between the two groups. No major complications were encountered. The laparoscopic hysterectomy group had a significantly lower postoperative morphine consumption (median 5.5 vs 14 mg, P < .05), lower febrile morbidity rate (15% vs 45.8%, P < .05), and shorter hospital stay (median 4 vs 6 days, P < .001) and demonstrated a less intense stress response in terms of serum interleukin-6 (median 50.6 vs 73.9 pg/mL × hour × 10, P = .01), C-reactive protein (median 28.1 vs 44.7 mg/L × hour × 10 2, P = .005), cortisol (median 23.4 vs 27.2 mg/mL × hour × 10 3, P = .04), white blood cell count (median 59.5 vs 69.8 10 9 /L × hour × 10, P = .009), 24-hour urinary excretion of cortisol (median 34.8 vs 44.2 nmol/L × hour × 10 3, P = .02), and norepinephrine (median 80.8 vs 132.4 nmol/L × hour × 10 2, P = .001). No significant difference was detected in plasma glucose (median 41.5 vs 45.6 mmol/L × hour × 10, P = 6) and 24-hour urinary excretion of epinephrine (median 32.2 vs 34.1 nmol/L × hour × 10 2, P = .3). CONCLUSION: Laparoscopic hysterectomy is associated with a lower morbidity and a less intense stress response than abdominal hysterectomy for benign diseases. (Am J Obstet Gynecol 1998;179:1-5.)
ISSN:0002-9378
1097-6868
DOI:10.1016/S0002-9378(98)70243-1