Assessment of Immunological Markers in Laparoscopy and Abdominal Hysterectomy

Background & Objective: Laparoscopy Hysterectomy (LH) is hypothesized to induce less surgical stress and immune impairment than Abdominal Hysterectomy (AH). This study was conducted with aim to compare perioperative immune responses between laparoscopy and abdominal hysterectomy.Materials & Methods: This prospective study was conducted on 100 women (50 in LH group, 50 in AH group). Blood samples were collected preoperatively at 24-, 48-, and 72-hours’ post-surgery. Cytokine levels were measured via ELISA and T-cell subsets via flow cytometry.Results: AH triggered a significantly stronger IL-17 surge postoperatively (38.4±1.05 to 92.89±8.04 pg/mL; P<0.0001) compared to LH (36.32±0.46 to 45.02±1.43 pg/mL). Conversely, AH demonstrated a significant postoperative decrease in IL-6, while LH levels remained stable. AH also induced a significantly greater depletion of CD8⁺ T lymphocytes (43.59±0.57% to 34.3±0.82%; P<0.001) than LH. Both groups showed reductions in CD4⁺ T cells and TNF-α.Conclusion: These findings demonstrate distinct postoperative immune responses following hysterectomy. Although AH uniquely reduced IL-6 levels, suggesting resolution of baseline inflammation, it concurrently triggered a significantly greater elevation in IL-17 and more pronounced CD8+ T-cell depletion. Conversely, LH demonstrated superior attenuation of pro-inflammatory responses, evidenced by lower IL-17 levels and preserved CD8+ T-cell counts, while minimizing immunosuppression. Collectively, these immunological advantages of LH support its role in reducing surgical stress burden and promoting enhanced immune recovery.