TY - JOUR
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
U2 - 10.1016/j.ejso.2018.08.021
DO - 10.1016/j.ejso.2018.08.021
M3 - Article
VL - 44
SP - 1935
EP - 1941
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
SN - 0748-7983
IS - 12
ER -