title: Comparison of tissue trauma after abdominal, vaginal and total laparoscopic hysterectomy.
abstract: OBJECTIVE
  The aim of the study was to compare the extent of tissue trauma atter abdominal hysterectomy(AH), vaginal hysterectomy (VH), and total laparoscopic hysterectomy (TLH) using biochemical markers.
  
  
  METHODS
  Seventy-one patients requiring hysterectomy for benign uterine diseases were enrolled in the study and divided into three treatment groups: AH (n=24), VH (n=23), and TLH (n=24). Blood samples for assay of interleukin-6 (IL-6) and creatine phosphokinase (CPK) were collected pre-, intra-operatively and 2, 6 and 24 h after surgery.
  
  
  RESULTS
  Serum levels of IL-6, and CPK were significantly elevated over basal values after surgery in all groups. IL-6 and CPK levels were significantly higher after AH as compared to VH and TLH. IL-6 concentrations were significantly higher in the VH group than the TLH group (p=0.00 1). There were no significant differences in CPK levels between the VH and TLH groups (p=0.824). TLH group had the smallest decrease in blood hemoglobin concentration and the shortest hospital stay
  
  
  CONCLUSIONS
  AH causes more tissue trauma as compared to VH and TLH. Owing to the fact that TLH is associated with less tissue trauma and offers significant clinical benefits, including less blood loss and shorter hospital stay it should be considered in women with benign gynecologic conditions, especially in experienced centers.
authors.forename: Aysegul
authors.initials: A
authors.lastname: Oksuzoglu
authors.forename: Berna
authors.initials: B
authors.lastname: Seckin
authors.forename: Ayse Figen
authors.initials: AF
authors.lastname: Turkcapar
authors.forename: Sarp
authors.initials: S
authors.lastname: Ozcan
authors.forename: Tayfun
authors.initials: T
authors.lastname: Gungor
mesh_terms: D000328:Adult; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D015850:Interleukin-6 / Q000097:blood*; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D017695:Soft Tissue Injuries / Q000276:immunology*; D013312:Stress, Physiological / Q000276:immunology*; D014594:Uterine Neoplasms / Q000601:surgery
chemical_list: D015850:Interleukin-6; D003402:Creatine Kinase