Endometrial carcinoma: The perioperative and long-term outcomes of robotic surgery in the morbidly obese

Shirley J. Hinshaw, Stephanie Gunderson, Daniel Eastwood, William H. Bradley
In: Journal of Surgical Oncology · 2016 · vol. 114(7) , pp. 884–887 · doi:10.1002/jso.24417 · PMID:27566529 · W2512491518
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Robotic hysterectomy for endometrial cancer in morbidly obese patients resulted in fewer postoperative complications and shorter hospital stays compared to open surgery, with similar operative times and oncologic outcomes.

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Abstract

BACKGROUND AND METHODS: To evaluate surgical and pathologic outcomes of robotic assisted versus open hysterectomy for women with at least class II (BMI >35) and class III (BMI >40) obesity with endometrial cancer. Women with endometrial cancer and class II obesity, treated with open or robotic hysterectomy between 3/2005 and 3/2013 were eligible for inclusion in this retrospective cohort. Patients with class III obesity were reviewed both within the cohort of class II and as a separate subset. Data were collected on demographics, operative statistics, pathology, post-operative complications, and oncologic outcomes. Tests of significance used Chi-square, Fisher's exact test, t-test, and Wilcoxon rank-sum. RESULTS: One hundred and thirty-six women with BMI >35 who underwent hysterectomy (56 robotic and 80 abdominal) were included. Patients undergoing robotic hysterectomies had fewer post-operative complications, shorter hospital stays, and lower blood loss compared to the abdominal group. A subset (83 of 136) with class III obesity had similar findings. Operative times, lymph node dissection rates, and lymph node yield (both pelvic and para-aortic) were similar between open and robotic surgery in both obesity classes. Oncologic outcomes and use of adjuvant treatment was not compromised. CONCLUSIONS: Robotic hysterectomy is a safe and effective option for morbidly obese women with endometrial cancer. J. Surg. Oncol. 2016;114:884-887. © 2016 2016 Wiley Periodicals, Inc.

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