title: [Tissue damage in alternative types of hysterectomy: prospective study].
abstract: OBJECTIVE
  To assess and compare tissue damage during alternative hysterectomies.
  
  
  METHODS
  Prospective clinical study.
  
  
  METHODS
  Department of Gynaecology, Endoscopic Training Centre, Kladno Hospital.
  
  
  METHODS
  Tissue damage and perioperative parameters were assessed using the enzymatic activity of creatine kinase (CK) and C-reactive protein (CRP). Serum levels of these markers were measured in 127 women who underwent laparoscopic, abdominal and vaginal hysterectomy.
  
  
  RESULTS
  The rare of CK activity and CRP were significantly greater in 45 patients who underwent abdominal hysterectomy compared with that in the patients who underwent laparoscopic and vaginal hysterectomies (57 and 25 patients, respectively).
  
  
  CONCLUSIONS
  Clinical experience and metabolic changes indicate that the tissue damage and perioperative stress in patients undergoing laparoscopic hysterectomy is lower than in patients where an abdominal approach is used. Large prospective studies are needed to evaluate the surgical trauma and metabolic changes induced by laparoscopic hysterectomy.
authors.affiliation: Gynek.-porod. oddĕlení, Nemocnice Kladno.
authors.forename: Z
authors.initials: Z
authors.lastname: Holub
authors.forename: A
authors.initials: A
authors.lastname: Jabor
authors.forename: D
authors.initials: D
authors.lastname: Fischlová
authors.forename: V
authors.initials: V
authors.lastname: Palásek
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007045:Hysterectomy, Vaginal / Q000009:adverse effects; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D003402:Creatine Kinase