Tissue trauma and inflammatory response following laparoscopic versus abdominal hysterectomy: a prospective randomized clinical trial

Background: Laparoscopic surgery is associated with more favorable clinical outcome than conventional open surgery. This might be related to the magnitude of tissue trauma and tissue stress response. This study compares the intensity of tissue injury by assessing plasma C-reactive protein (CRP), lactic dehydrogenase (LDH), and cancer antigen 125 (CA 125) in patients undergoing laparoscopic hysterectomy compared to abdominal hysterectomy.Methods: This study was conducted at Ain Shams University Maternity Hospital from May 2018 to February 2020. 74 women candidate for hysterectomy were recruited and randomized into two groups: group A included 37 cases who underwent abdominal hysterectomy, and group B included 37 cases that underwent laparoscopic hysterectomy.Results: CRP, LDH and CA125 significantly increased post-operatively in both groups. Postoperative mean serum CRP, LDH and CA125 were significantly higher in the laparotomy group (10.84±2.47, 262.21±76.77, and 13.41±2.6 respectively) compared to laparoscopy group (7.92±2.25, 148.53±43.56, 11.79±2.77 respectively) (p<0.05).Conclusions: Surgery is a significant cause of tissue injury that can be assessed by specific markers. We suggest that laparoscopic surgery causes less tissue damage as assessed by lower postoperative CRP and LDH values, which might account for the earlier recovery and reduced hospital stay in laparoscopic surgery.