Effect of abdominal, vaginal and laparoscopic hysterectomy on total oxidant/antioxidant levels, ischemia modified albumin and thiol/disulfide homeostasis

Objective: In our study, abdominal, vaginal and laparoscopic hysterectomy techniques caused systemic oxidative stress, total oxidant status (tos), total antioxidant level (TAS), oxidative stress index (OSI), thiol-disulfide (T – Ds) homeostasis, ischemia-modified albumin (IMA) aimed to evaluate markers using. Material and Method: This prospective case-control study included 66 cases in Ankara Yıldırım Beyazıt University Ankara City Hospital Gynecology and Obstetrics Clinic, including 22 cases from each group for whom abdominal, vaginal and laparoscopic hysterectomy was planned for benign gynecological reasons. Demographic and clinical features of cases were recorded. Blood samples were taken at post-operative 0th and post-operative 24th hour, and total oxidant level, total antioxidant level, thiol - disulfide levels, ischemia-modified albumin and complete blood count parameters were evaluated. One-way ANOVA test and Kruskal Wallis test were used to compare the data between groups. The dependent sample T test and repeated measurements variance analysis (ANOVA) test were used to analyze the change of data according to time. Chi-Square test was used to compare categorical data. P < 0.05 was considered significant in statistical tests and P < 0.017 (0.05 / 3) was considered significant in post-hoc correction tests. Results: Median age was significantly higher in VH group than AH and LH groups (p <0.05). On the other hand, while the median of the gravida was 2.5 in all cases, it was significantly higher in VH group than AH and LH groups (p <0.05). Operation time was significantly longer in LH and VH groups than AH group (p <0.05). When evaluated in terms of serum TOS levels, pre-operative serum TOS level was significantly higher in VH group than AH and LH groups (p <0.05). It was observed that TOS levels in AH and LH groups increased significantly compared to the pre-operative level in post-operative 0th hour compared to VH group (p values 0.005 and 0.005, respectively). In terms of serum OSI level, it was observed that serum OSI level in AH and LH groups increased significantly at post-operative 0th hour compared to pre-operative level (p <0.05). Among the markers, serum native thiol level was significantly higher in LH group compared to AH and VH groups during pre-operative period, while serum disulfide level was significantly lower in LH group than other groups at post-operative 24th hour (p values <0.005). Post-operative 24. serum NT/TT (%) value per hour was significantly higher in LH Group than other groups (p < 0.05); DS/NT (%) value was significantly lower in LH Group than other groups (p < 0.05). When we look at the serum implication value, postoperative 0 in LH Group. post-operative 24 after a non-meaningful reduction in hours. there was a significant increase per hour (p < 0.05). However, there was no significant difference between groups in terms of serum implication levels (p < 0.05) Conclusions: The serum oxidative stress markers we evaluated and the different hysterectomy techniques were not able to come to a common conclusion. However, our study showed that vaginal and laparoscopic procedures, which are minimally invasive techniques, cause less systemic oxidative stress compared to abdominal hysterectomy. Keywords: Hysterectomy, laparoscopic hysterectom, oxidative stress, vaginal hysterectomy