Purpose: To test the hypothesis that laparoscopic-assisted vaginal hysterec
tomy (LAVH) attenuates the hyperglycemic response to surgery when compared
to vaginal hysterectomy (VH).
Methods: Fourteen patients received either LAVH (n=7) or VH (n=7). Whole bo
dy glucose production was measured before and three hours after surgery usi
ng [6.6(-2) H,] glucose. Before, during and after the operation, plasma con
centrations of glucose, insulin, glucagon, cortisol, epinephrine and norepi
nephrine were determined.
Results: Plasma glucose concentration increased in both groups during and a
fter surgery showing a significantly higher value after VH than after LAVH
(VH: 8.3 +/- 1.4 mmol(.)L(-1); LAVH: 6.6 +/- 0.9 mmol(.)L(-1), P < 0.05). T
he postoperative increase in glucose production was comparable in both grou
ps. While plasma concentrations of insulin and glucagon remained unchanged,
intra- and postoperative plasma cortisol concentrations were significantly
higher in the VH group than in the LAVH group. Plasma catecholamine concen
trations significantly increased after both types of surgery to the same ex
Conclusion: In this observational study, LAVH appears to blunt the hypergly
cemic and cortisol response to surgery when compared to VH.