Prospective-controlled assessment of stress hormones and pain in patients undergoing myomectomy as performed by laparoscopy against laparotomy

George Pados, Konstantinos Katrantsiotis, Dimitrios Tsolakidis, Kostantinos Almaloglou, Spiros Gerou
2020 · doi:10.21203/rs.3.rs-26683/v1 · W3175867314
preprint OA: gold CC0
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

Laparoscopic myomectomy resulted in significantly lower postoperative stress hormones (ACTH and noradrenalin) and pain compared to laparotomy.

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Abstract

Abstract PurposeThe objective of the study is to prospectively assess surgical stress and postoperative pain after myomectomy performed by laparoscopy versus laparotomyMethodsThis prospective, matched, multi-center observational study, took place in the Gynecological Department of the “Papageorgiou" University Hospital and the Centre for Gynecological Endoscopy, “Diavalkaniko” Hospital. Sixty women with symptomatic growth of known uterine leiomyomas or leiomyomas compromising the shape of the uterus participated in the study. Thirty women underwent laparoscopic myomectomy, and another thirty had removal of leiomyomas through laparotomy from November 2016 to February 2018. Three venous samples were obtained from each patient to determine stress hormones (one before surgery, the second at the end of the surgical procedure, and the third on the morning of the first postoperative day), and a questionnaire was administered on the first postoperative day, in which patients indicated the level of pain through a Visual Analog Scale for Pain (VASP).ResultsAdrenocorticotropic hormone (ACTH) and noradrenalin were significantly lower in the laparoscopic group on the first postoperative day (12.68 ± 9.97 pg/ml vs 15.90 ± 9.02 pg/ml, p<0.025) and 20.7 ± 7.28 ng/ml vs 22.33 ± 5.82 ng/ml, p0.94) and also for β-endorphin levels (4.88 ± 1.57 vs 4.91 ± ng/ml, p>0.61). The postoperative pain was significantly lower in the laparoscopic group on the VASP scale (3.3 ± 1.05 vs 5.67 ± 1.15, p<0.001, respectively).ConclusionLaparoscopy is superior to laparotomy for the surgical removal of leiomyomas in terms of postoperative pain and surgical stress.

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