title: Prospective comparison of tissue trauma after laparoscopic hysterectomy types with retroperitoneal lateral transsection of uterine vessels using ligasure and abdominal hysterectomy.
abstract: OBJECTIVE
  The aim of this study was to evaluate the level of tissue trauma after laparoscopic and total laparoscopic hysterectomy with retroperitoneal lateral transsection of uterine vessels using ligasure as compared with abdominal hysterectomy.
  
  
  METHODS
  A total of 45 women with various indications for hysterectomy were randomized into laparoscopic hysterectomy, total laparoscopic hysterectomy and abdominal hysterectomy. Laparoscopic and total laparoscopic hysterectomy with retroperitoneal lateral transsection of uterine vessels was performed by four-puncture laparoscopy and pre-, postoperative and postoperative 24th hour levels of interleukin-6 (IL-6) and C-reactive protein (CRP), the mean operative time, drop in hemoglobin concentration, weight of removed uterus, VAS scores, hospitalization period and major and minor operative complications were analyzed prospectively.
  
  
  RESULTS
  CRP and IL-6 levels were significantly higher in the abdominal hysterectomy group compared to either laparoscopy groups at the postoperative 24th hour. There were no significant differences in the levels of CRP and IL-6 between the two laparoscopy groups. The longest operative times were observed in the total laparoscopic hysterectomy group.
  
  
  CONCLUSIONS
  Laparoscopic surgery causes less tissue trauma than the conventional open surgery; however, we observed no difference between the laparoscopic hysterectomy groups concerning the postoperative inflammatory response. We may prefer laparoscopic hysterectomy instead of total laparoscopic hysterectomy under suitable conditions, since laparoscopic hysterectomy causes the same level of tissue trauma as total laparoscopic hysterectomy, but has the advantage of a significantly shorter operative time. Meanwhile, hysterectomy done by laparoscopy with retroperitoneal lateral transsection of uterine vessels using ligasure is an effective and safe procedure.
authors.affiliation: Department of Obstetrics and Gynecology, Dokuz Eylül University Hospital, Narlidere, Izmir, Turkey. ahmet_demir77@hotmail.com
authors.forename: Ahmet
authors.initials: A
authors.lastname: Demir
authors.forename: Ozgur
authors.initials: O
authors.lastname: Bige
authors.forename: Bahadir
authors.initials: B
authors.lastname: Saatli
authors.forename: Ahmet
authors.initials: A
authors.lastname: Solak
authors.forename: Uğur
authors.initials: U
authors.lastname: Saygili
authors.forename: Ata
authors.initials: A
authors.lastname: Onvural
mesh_terms: D000328:Adult; D000368:Aged; D001158:Arteries / Q000601:surgery; D016063:Blood Loss, Surgical; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods*; D007249:Inflammation; D015850:Interleukin-6 / Q000097:blood*; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D012187:Retroperitoneal Space / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey; D014599:Uterus / Q000098:blood supply* / Q000601:surgery
chemical_list: D015850:Interleukin-6; D002097:C-Reactive Protein