Laparoscopic versus robotic hysterectomy in obese and extremely obese patients with endometrial cancer: A multi-institutional analysis

Giacomo Corrado, Enrico Vizza, Vito Cela, Liliana Mereu, Stefano Bogliolo, Francesco Legge, Francesca Ciccarone, Emanuela Mancini, Valerio Gallotta, Ermelinda Baiocco, Giorgia Monterossi, Maria Teresa Perri, Ashanti Zampa, Tina Pasciuto, Giovanni Scambia

Research output: Contribution to journalArticle

Abstract

Objective: The aim of this study was to evaluate the surgical and oncological outcome of robotic surgical staging with hysterectomy (RH) plus or less pelvic and aortic lymphadenectomy, compared to the same procedures performed by laparoscopic surgery (LH) in obese patients (BMI≥30 kg/m2) with endometrial cancer. Material and methods: From October 2001 to April 2017, obese patients (BMI > 30 kg/m2) with primary, histologically confirmed endometrial carcinoma who underwent LH or RH using the Da Vinci Si or Xi Surgical System® (Intuitive Surgical Inc®, 1266 Kifer Road, Building 101 Sunnyvale, CA) were eligible for the study. Results: We identified 655 women with endometrial cancer and BMI >30 kg/m2. Out of 655 patients, 249 (38%) underwent RH and 406 (62%) underwent LH plus or less pelvic and aortic lymphadenectomy. Our study showed that, compared to the 406 patients treated in LPS, 249 patients treated in robotics have a statistically significant difference in terms of increased operating time and a decreased conversion rate. In addition, the rate of pelvic lymphadenectomies in robotic surgeries is twice the one reported in LPS surgeries. Furthermore, a reduction in hospital stay was observed in the robotic group. We observed that the oncological outcomes do not vary according to the surgical approach and BMI variation. Conclusions: robotic surgery in severely obese women with endometrial cancer is feasible, safe, and reproducible and could be a valid alternative to laparoscopy in the treatment of these patients. Prospective studies could confirm our results.

Original languageEnglish
Pages (from-to)1935-1941
Number of pages7
JournalEuropean Journal of Surgical Oncology
Volume44
Issue number12
DOIs
Publication statusPublished - Dec 1 2018

Keywords

  • Endometrial cancer
  • Innovative biotechnology
  • Laparoscopic hysterectomy
  • Obese patients
  • Personalized approach
  • Robotic hysterectomy

ASJC Scopus subject areas

  • Surgery
  • Oncology

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