Robotic-assisted hysterectomy is an alternative to laparoscopic surgery as part of a minimal
invasive regimen. Several treatment strategies are followed to improve the overall outcome
and minimize surgical stress. Glucocorticoids provide significant analgesic and antiemetic
effects but its role in a fast-track, multi-modal setting is not settled when discharge is
planned within 24-36 hours.
This study will evaluate in a randomized trial the effect of a single dose of 24 mg
dexamethasone on women undergoing robotic-assisted hysterectomy with regard to surgical
stress measured by c-reactive protein as primary outcome and, further, other stress markers
like white blood cells, Il-6, cortisol, and creatinine kinase. The postoperative recovery
will be registered in validated charts and questionnaires for pain and analgesic use, quality
of recovery, incontinence, sexual and work life. Furthermore, in a sub-analysis,
transcriptional profiling will be applied to explore, which parts of the innate and cellular
immune system is activated to explore the mechanisms of surgical stress response.
The hypothesis is that women undergoing robotic hysterectomy would benefit from peroperative
glucocorticoid treatment on important life qualities like pain, fatigue, freedom of
medications and resuming work and sexual activities. Further, future adjuvant peroperative
regimens may be able to target the stress response in a more appropriate way