Role of interleukin -6 (IL-6) in evaluating surgical stress after total abdominal hysterectomy (TAH) and non — descent vaginal hysterectomy (NDVH)

Abstract

Aim: to compare surgical stress between (TAH) and (NDVH) in women whom hysterectomy is indicated for benign disease by perioperative inflammatory response using interleukin-6 (IL6) and perioperative clinical outcomes. Patients & Methods: Twenty patients with benign uterine disease and failed medical treatment with uterine size <12 weeks were randomized into two equal group for either TAH or NDVH. Serum levels of IL6 In venous blood were analyzed preoperatively and 3, 24,72 hour after beginning of surgery. Intraoperative, postoperative clinical outcome measure and surgery related morbidity were also, evaluated in both groups. Statistical analysis was done using medcalc software bvba 2016. Results: There was no statistically significant difference present in demographic characteristics, operative duration and uterine weight between TAH and NDVH groups. No major complications were occurred. There was statistically significant increase in serum IL6 level from preoperative value to the 3 hours value after beginning of surgery in TAH group when compared with NDVH group, indicating greater tissue trauma in TAH group. There was statistically significant results in favour of NDVH over TAH as regards hospital stay, pain score, need for analgesia, wound infection, recuperation time (P < 0.05). Conclusion: NDVH is better than TAH for uteri less than 12 weeks in terms of perioperative inflammatory response and clinical outcome measures.

Hysterectomy in morbidly obese women: a retrospective comparative analysis of routes vaginal versus abdominal in Benha University hospital

“…Studies after 1976 rarely compare TAH to VH in obese, despite the availability of studies comparing TAH to total laparoscopic and robotic hysterectomy (TLH) (6,17 14,32,36,37). Moreover, our prior prospective studies didn't address this sector of women (10)(11)(12)(13). A recent retrospective analysis in 2017 investigate VH in morbidly obese comparing conventional suturing technique to vessel sealing technology reported very low conversion rate as well as very low complication rate (23), but it only compared vaginal to vaginal and conducted on morbidly obese women with average BMI.…”

“…In the United States, 66% of hysterectomies are executed abdominally, and 22% are executed vaginally (7), while in Egypt there is underutilization of the vaginal route and nearly gynecologic surgeon in charge deliberated morbid obesity as a contraindication for vaginal hysterectomies and only a few gynecologists nationwide who practiced non-descent vaginal hysterectomy as a trial based routine gynecologic practice (10)(11)(12)(13).…”

Outcomes of Hysterectomy in Women with Prior Cesarean Section: Retrospective Analysis of Non-Descent Vaginal Hysterectomy (NDVH) Versus Abdominal Hysterectomy (TAH) in Benha University Hospital

“…Coulam and Pratt [21] found early at 1973 in their retrospective analysis that a prior CS isn't a contraindication to TVH however it seems that the tittle of the article was misleading and was understood in opposite direction as this was the concept of surveyed gynecologists in USA and UK [22,23] . In Egypt vaginal root for HR is preserved for prolapse even in such situation some operated abdominal or laparoscopic, and only few gynecologists had the concept of trialing most candidates for HR vaginally [24,25,26,27] .…”