Effects of laparoscopically-assisted vaginal hysterectomy compared with abdominal hysterectomy on immune function.

This study evaluated the effects of laparoscopically assisted vaginal hysterectomy (LAVH) and abdominal hysterectomy (AH) on the immune system. Between May 2007 and July 2008, 84 women with uterine myoma were randomized in a double-blind manner to undergo LAVH (n = 42) or AH (n = 42). Plasma levels of interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-alpha), C-reactive protein (CRP), T-lymphocyte CD3(+), CD4(+) and CD8(+) subpopulations, and natural killer (NK) cells were measured 24 h before and 24 h and 72 h after surgery. The IL-6, TNF-alpha and CRP levels in both groups increased significantly after surgery compared with pre-operative levels, and were significantly lower in the LAVH versus the AH group. Post-operative CD3(+) and CD8(+) T-cell counts in the AH group decreased significantly compared with pre-operative levels, whereas in the LAVH group they decreased but not to a statistically significant degree. Post-operative CD4(+) T-cell counts in the AH group also decreased significantly at 24 h after surgery, but were significantly increased at 72 h. In conclusion, LAVH does not significantly affect immune function compared with AH, suggesting the preservation of post-operative immunity, however further clinical studies are necessary.