Effect Of Laparoscopic Hysterectomy And Abdominal Hysterectomy On Cell Immune Function In Patients

Objective:To study the effect of laparoscopic hysterectomy and abdominal hysterectomy on cell immune function.This study was designed to explore the effect of laparoscopic hysterectomy and abdominal hysterectomy on the host immune response in patients with benign gynecologic disorders required to operation. Alterations in peripheral blood leukocyte count,cytokine(interleukin-2 and interleukin-4) levels in serum and neutrophilic granulocyte rate of tissue trauma and inflammatory reaction.By assaying the above parameters and recording patients' recovery situations during para-operative period,we evaluated differences in the systemic immune response and clinical outcome after laparoscopic and conventional surgical approaches(open surgery).Based on above findings,We try to provide further evidences for minimum incisions induced by the laparoscopic procedures.Methods:Sixty women who suffered from gynaecol benign diseases and had hysterectomy signs were divided into 2 groups,undergoing laparoscopic hysterectomy(LH) and abdominal hysterectomy(AH) with 30 in each group.The white blood cell(WBC),neutrophilic granulocyte rate were in finger blood at 1 day before and 1 day after operation,interleukin-2(IL-2),interleukin-4(IL-4) at 1 day before and 1 and 4 days after operation were measured.Operation time,bleed amount in operation, postoperative exhausting time and postoperative morbidity were compared between the two groups.Rsults:①The WBC count and neutrophil granulocyte rate were increased significantly in abdominal hysterectomy group(P＜0.05)but not in laparoscopic hysterectomy group(P＞0.05).②The level of IL-4 was not increased significantly after operation in laparoscopic hysterectomy group,whereas it was increased significantly in abdominal hysterectomy group,and there was greater difference between two groups (P＜0.05).The level of IL-2 was decreased significantly at 1 day after operation in two groups,but it was gradually increased to the level of preoperation at 4 day after laparoscopic hysterectomy(P>0.05)and was still lower significantly at 4 day after abdominal hysterectomy than preoperation(P＜0.05).③Compared with abdominal hysterectomy group,laparoscopic hysterectomy group had less operation bleeding,shorter postoperative exhausting time and lower febrile morbidity (P＜0.05).Conclusion:The WBC count,neutrophil granulocyte rate and the level of IL-4 were lower significantly after laparoscopic surgery than abdominal hysterectomy group.The level of IL-2 was decreased significantly at 1 day after operation in two groups,but it was gradually increased to the level of preoperation at 4 day after laparoscopic hysterectomy. Laparoscopic surgery has a more favorable clinical outcome because of less tissue trauma. Significant immune suppression in mononuclear phagocytic system was demonstrated after operation,but the degree of inhibition after Laparoscopic hysterectomy is lower than that after abdominal hysterectomy.Laparoscopic techniques are feasible for curing benign gynecologic disorders whenever possible because of potential benefit.