Journal article
Robotic surgery in supermorbidly obese patients with endometrial cancer
American Journal of Obstetrics and Gynecology, Vol.213(1), pp.49.e1-49.e8
07/2015
DOI: 10.1016/j.ajog.2015.01.052
PMID: 25644437
Abstract
Morbid obesity is a known risk factor for the development of endometrial cancer. Several studies have demonstrated the overall feasibility of robotic-assisted surgical staging for endometrial cancer as well as the benefits of robotics compared with laparotomy. However, there have been few reports that have evaluated robotic surgery for endometrial cancer in the supermorbidly obese population (body mass index [BMI], ≥50 kg/m2). We sought to evaluate safety, feasibility, and outcomes for supermorbidly obese patients who undergo robotic surgery for endometrial cancer, compared with patients with lower body mass indices. We performed a retrospective chart review of 168 patients with suspected early-stage endometrial adenocarcinoma who underwent robotic surgery for the management of their disease. Analysis of variance and univariate logistic regression were used to compare patient characteristics and surgical variables across all body weights. Cox proportional hazard regression was used to determine the impact of body weight on recurrence-free and overall survival. The mean BMI of our cohort was 40.9 kg/m2. Median follow up was 31 months. Fifty-six patients, 30% of which had grade 2 or 3 tumors, were supermorbidly obese with a BMI of ≥50 kg/m2 (mean, 56.3 kg/m2). A comparison between the supermorbidly obese and lower-weight patients demonstrated no differences in terms of length of hospital stay, blood loss, complication rates, numbers of pelvic and paraaortic lymph nodes retrieved, or recurrence and survival. There was a correlation between BMI and conversion to an open procedure, in which the odds of conversion increased with increasing BMI (P = .02). Offering robotic surgery to supermorbidly obese patients with endometrial cancer is a safe and feasible surgical management option. When compared with patients with a lower BMI, the supermorbidly obese patient had a similar outcome, length of hospital stay, blood loss, complications, and numbers of lymph nodes retrieved.
Details
- Title: Subtitle
- Robotic surgery in supermorbidly obese patients with endometrial cancer
- Creators
- Jean-Marie Stephan - Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, IAMichael J Goodheart - Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, IAMegan McDonald - Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, IAJean Hansen - Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, IAHenry D Reyes - Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, IAAnna Button - Department of Biostatistics, University of Iowa Hospitals and Clinics, Iowa City, IADavid Bender - Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, IA
- Resource Type
- Journal article
- Publication Details
- American Journal of Obstetrics and Gynecology, Vol.213(1), pp.49.e1-49.e8
- DOI
- 10.1016/j.ajog.2015.01.052
- PMID
- 25644437
- NLM abbreviation
- Am J Obstet Gynecol
- ISSN
- 0002-9378
- eISSN
- 1097-6868
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 07/2015
- Academic Unit
- Obstetrics and Gynecology
- Record Identifier
- 9983931635102771
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