Inflammatory response and tissue trauma in laparoscopic hysterectomy: comparison of electrosurgery and harmonic scalpel.
OBJECTIVE
Our aim was to quantify and compare clinical outcome and surgical inflammatory response and tissue trauma after laparoscopic hysterectomy for a benign disorder which was performed by electrosurgery or harmonic scalpel.


METHODS
Sixty patients scheduled for laparoscopic hysterectomy were selected according to patient preference to undergo either electrosurgery or an ultrasonic operative technique. Blood samples for assay of markers of tissue trauma (C-reactive protein, interleukin-6, creatine kinase, white blood cell count) were taken preoperatively, on the first and third postoperative day. Three patients with intraoperative complications or incomplete records were excluded from tissue analysis.


RESULTS
No differences were present in the demographic characteristics and clinical outcomes (blood loss, uterine weight, operating time and hospital stay) in 57 uncomplicated laparoscopic hysterectomies. Both electrosurgery (n = 36) and use of the harmonic scalpel (n = 21) resulted in statistically significant changes in the inflammatory and systemic immune response in comparison with preoperative values. No significant differences were observed in the studied inflammatory and tissue markers (C-reactive protein, interleukin-6, creatine kinase and white blood cells) between the compared groups.


CONCLUSIONS
The harmonic scalpel and electrosurgery in laparoscopic hystsrectomy were equally traumatic in terms of surgical inflammatory response and tissue trauma.
Holub
Z
Z
Department of Gynaecology and Obstetrics, Endoscopic Training Center Hospital Kladno, Czech Republic.
Jabor
A
A
Sprongl
L
L
Kliment
L
L
Fischlová
D
D
Urbánek
S
S
D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis; D003402:Creatine Kinase / Q000097:blood; D004598:Electrosurgery; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000295:instrumentation / Q000379:methods*; D007249:Inflammation / Q000503:physiopathology; D015850:Interleukin-6 / Q000097:blood; D010535:Laparoscopy; D008875:Middle Aged; D011446:Prospective Studies; D013312:Stress, Physiological / Q000503:physiopathology*
D015850:Interleukin-6; D002097:C-Reactive Protein; D003402:Creatine Kinase