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

G. Corrado, E. Vizza, V. Cela, L. Mereu, S. Bogliolo, F. Legge, F. Ciccarone, E. Mancini, V. Gallotta, E. Baiocco, G. Monterossi, M. T. Perri, A. Zampa, T. Pasciuto, G. 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>/=30kg/m(2)) with endometrial cancer. MATERIAL AND METHODS: From October 2001 to April 2017, obese patients (BMI>30kg/m(2)) with primary, histologically confirmed endometrial carcinoma who underwent LH or RH using the Da Vinci Si or Xi Surgical System((R)) (Intuitive Surgical Inc((R)), 1266 Kifer Road, Building 101 Sunnyvale, CA) were eligible for the study. RESULTS: We identified 655 women with endometrial cancer and BMI >30kg/m(2). 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

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Robotics
Endometrial Neoplasms
Hysterectomy
Lymph Node Excision
Laparoscopy
Gonadotropin-Releasing Hormone
Length of Stay
Prospective Studies

Keywords

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

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Laparoscopic versus robotic hysterectomy in obese and extremely obese patients with endometrial cancer: A multi-institutional analysis. / Corrado, G.; Vizza, E.; Cela, V.; Mereu, L.; Bogliolo, S.; Legge, F.; Ciccarone, F.; Mancini, E.; Gallotta, V.; Baiocco, E.; Monterossi, G.; Perri, M. T.; Zampa, A.; Pasciuto, T.; Scambia, G.

In: European Journal of Surgical Oncology, Vol. 44, No. 12, 01.12.2018, p. 1935-1941.

Research output: Contribution to journalArticle

Corrado, G, Vizza, E, Cela, V, Mereu, L, Bogliolo, S, Legge, F, Ciccarone, F, Mancini, E, Gallotta, V, Baiocco, E, Monterossi, G, Perri, MT, Zampa, A, Pasciuto, T & Scambia, G 2018, 'Laparoscopic versus robotic hysterectomy in obese and extremely obese patients with endometrial cancer: A multi-institutional analysis', European Journal of Surgical Oncology, vol. 44, no. 12, pp. 1935-1941. https://doi.org/10.1016/j.ejso.2018.08.021
Corrado, G. ; Vizza, E. ; Cela, V. ; Mereu, L. ; Bogliolo, S. ; Legge, F. ; Ciccarone, F. ; Mancini, E. ; Gallotta, V. ; Baiocco, E. ; Monterossi, G. ; Perri, M. T. ; Zampa, A. ; Pasciuto, T. ; Scambia, G. / Laparoscopic versus robotic hysterectomy in obese and extremely obese patients with endometrial cancer: A multi-institutional analysis. In: European Journal of Surgical Oncology. 2018 ; Vol. 44, No. 12. pp. 1935-1941.
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T1 - Laparoscopic versus robotic hysterectomy in obese and extremely obese patients with endometrial cancer: A multi-institutional analysis

AU - Corrado, G.

AU - Vizza, E.

AU - Cela, V.

AU - Mereu, L.

AU - Bogliolo, S.

AU - Legge, F.

AU - Ciccarone, F.

AU - Mancini, E.

AU - Gallotta, V.

AU - Baiocco, E.

AU - Monterossi, G.

AU - Perri, M. T.

AU - Zampa, A.

AU - Pasciuto, T.

AU - Scambia, G.

N1 - LR: 20180924; CI: Copyright (c) 2018; JID: 8504356; OTO: NOTNLM; 2018/06/04 00:00 [received]; 2018/08/14 00:00 [revised]; 2018/08/28 00:00 [accepted]; 2018/09/25 06:00 [entrez]; 2018/09/25 06:00 [pubmed]; 2018/09/25 06:00 [medline]; aheadofprint

PY - 2018/12/1

Y1 - 2018/12/1

N2 - 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>/=30kg/m(2)) with endometrial cancer. MATERIAL AND METHODS: From October 2001 to April 2017, obese patients (BMI>30kg/m(2)) with primary, histologically confirmed endometrial carcinoma who underwent LH or RH using the Da Vinci Si or Xi Surgical System((R)) (Intuitive Surgical Inc((R)), 1266 Kifer Road, Building 101 Sunnyvale, CA) were eligible for the study. RESULTS: We identified 655 women with endometrial cancer and BMI >30kg/m(2). 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.

AB - 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>/=30kg/m(2)) with endometrial cancer. MATERIAL AND METHODS: From October 2001 to April 2017, obese patients (BMI>30kg/m(2)) with primary, histologically confirmed endometrial carcinoma who underwent LH or RH using the Da Vinci Si or Xi Surgical System((R)) (Intuitive Surgical Inc((R)), 1266 Kifer Road, Building 101 Sunnyvale, CA) were eligible for the study. RESULTS: We identified 655 women with endometrial cancer and BMI >30kg/m(2). 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.

KW - Endometrial cancer

KW - Innovative biotechnology

KW - Laparoscopic hysterectomy

KW - Obese patients

KW - Personalized approach

KW - Robotic hysterectomy

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M3 - Article

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SP - 1935

EP - 1941

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

SN - 0748-7983

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