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Metabolic and inflammatory responses and subsequent recovery in robotic versus abdominal hysterectomy: A randomised controlled study
Örebro University, School of Medical Sciences. Department of Obstetrics and Gynaecology, Örebro University Hospital, Sweden.
Örebro University, School of Medical Sciences.
Örebro University, School of Medical Sciences. Department of Surgery, Örebro University Hospital, Sweden.ORCID iD: 0000-0003-2636-4745
2016 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, S0261-5614(16)31356-5Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND & AIMS: Surgery causes inflammatory and metabolic responses in the body. The aim of the study was to investigate whether robotic-assisted total laparoscopic hysterectomy induces less insulin resistance than abdominal hysterectomy, and to compare inflammatory response and clinical recovery between the two techniques.

METHODS: A randomised controlled study at the Department of Obstetrics and Gynaecology, Örebro University Hospital, Sweden. Twenty women scheduled for a planned total hysterectomy with or without salpingo-oophorectomy between October 2014 and May 2015, were randomly allocated to robotic-assisted total laparoscopic hysterectomy or abdominal hysterectomy. Insulin resistance after surgery was measured by the hyperinsulinemic normoglycaemic clamp method, inflammatory response measured in blood samples, and clinical recovery outcomes registered.

RESULTS: There were no differences in development of insulin resistance between the robotic group and the abdominal group (mean ± SD: 39% ± 22 vs. 40% ± 19; p = 0.948). The robotic group had a significantly shorter hospital stay (median 1 vs. 2 days; p = 0.005). Inflammatory reaction differed; in comparison to the robotic group, the abdominal group showed significantly higher increases in serum interleukin 6 levels, white blood cell count and cortisol from preoperative values to postoperative peak values.

CONCLUSIONS: Robotic laparoscopic surgery reduced inflammatory responses and recovery time, but these changes were not accompanied by decreased insulin resistance.

CLINICAL TRIAL REGISTRATION: www.ClinicalTrials.gov Identifier no NCT02291406.

Place, publisher, year, edition, pages
Elsevier, 2016. S0261-5614(16)31356-5
Keyword [en]
Hysterectomy, Inflammatory response, Insulin resistance, Robotic-assisted hysterectomy
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
URN: urn:nbn:se:oru:diva-58062DOI: 10.1016/j.clnu.2016.12.015PubMedID: 28043722OAI: oai:DiVA.org:oru-58062DiVA: diva2:1110621
Note

Funding Agencies:

Research Committee of Örebro County Council

Nyckelfonden

Stiftelsen Gynekologisk Onkologi

Lisa och Göran Grönbergs Stiftelse

Available from: 2017-06-16 Created: 2017-06-16 Last updated: 2017-06-16Bibliographically approved

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