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 × 10², P = .005), cortisol (median 23.4 vs 27.2 mg/mL × hour × 10³, P = .04), white blood cell count (median 59.5 vs 69.8 10<sup>9Cho JM, LaPorta AJ, Clark JR, Schofield MJ, Hammond SL, Maoolry PL Response of serum cytokines in patients undergoing laparoscopic cholecystectomy Surg Endosc 1994 ;  8 : 1380-1384

Cliquez ici pour aller à la section Références</sup>/L × hour × 10, P = .009), 24-hour urinary excretion of cortisol (median 34.8 vs 44.2 nmol/L × hour × 10³, P = .02), and norepinephrine (median 80.8 vs 132.4 nmol/L × hour × 10², 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 × 10², 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.)