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 x hour x 10, P = .01), C-reactive protein (median 28.1 vs 44.7 mg/L x hour x 10(2), P = .005), cortisol (median 23.4 vs 27.2 mg/mL x hour x 10(3), P = .04), white blood cell count (median 59.5 vs 69.8 10(9)/L x hour x 10, P = .009), 24-hour urinary excretion of cortisol (median 34.8 vs 44.2 nmol/L x hour x 10(3), P = .02), and norepinephrine (median 80.8 vs 132.4 nmol/L x hour x 10(2), P = .001). No significant difference was detected in plasma glucose (median 41.5 vs 45.6 mmol/L x hour x 10, P = 6) and 24-hour urinary excretion of epinephrine (median 32.2 vs 34.1 nmol/L x hour x 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.
RCT Entities:
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 x hour x 10, P = .01), C-reactive protein (median 28.1 vs 44.7 mg/L x hour x 10(2), P = .005), cortisol (median 23.4 vs 27.2 mg/mL x hour x 10(3), P = .04), white blood cell count (median 59.5 vs 69.8 10(9)/L x hour x 10, P = .009), 24-hour urinary excretion of cortisol (median 34.8 vs 44.2 nmol/L x hour x 10(3), P = .02), and norepinephrine (median 80.8 vs 132.4 nmol/L x hour x 10(2), P = .001). No significant difference was detected in plasma glucose (median 41.5 vs 45.6 mmol/L x hour x 10, P = 6) and 24-hour urinary excretion of epinephrine (median 32.2 vs 34.1 nmol/L x hour x 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.
Authors: Jason D Wright; Rosa R Cui; Anqi Wang; Ling Chen; Ana I Tergas; William M Burke; Cande V Ananth; June Y Hou; Alfred I Neugut; Sarah M Temkin; Y Claire Wang; Dawn L Hershman Journal: J Natl Cancer Inst Date: 2015-10-08 Impact factor: 13.506
Authors: Johanna W M Aarts; Theodoor E Nieboer; Neil Johnson; Emma Tavender; Ray Garry; Ben Willem J Mol; Kirsten B Kluivers Journal: Cochrane Database Syst Rev Date: 2015-08-12