title: [Endometrial cancer by laparoscopy and vaginal approach in the obese patient].
abstract: To prove feasibility of laparoscopic and vaginal surgical approach in obese patients with endometrial cancer, 81 patients were included retrospectively in 2 Cancer Centres : 41 obese and 40 non obese. We performed hysterectomy with oophorectomy and pelvic lymphadenectomy by laparoscopic and vaginal approach. Operative time was higher for obese patients vs non obese (150 vs 121 minutes, p = 0.01) but pelvic nodes (16.3 vs 16.2), postoperative stay (3.8 [2-8] vs 3.6 days [2-7]), complications and disease-free survival (93 % vs 83 %) were similar. Matching 41 obese patients treated by laparoscopy with 29 obese patients with endometrial cancer treated by laparotomy, hospital stay was shorter in the laparoscopic group (3.8 [2-8] vs 7.4 days [5-10] p < 0.001) and pelvic nodes (16.3 [3-50] vs 11.5 [2-34]), operative time (149.9 [80-300] vs 167.9 minutes [60-390]) and disease-free survival (93 vs 80 %) were similar. One patient treated by laparotomy never received intended radiotherapy because of a delay greater than 3 months caused by cutaneous necrosis. For obese patients with stage I endometrial adenocarcinoma, laparoscopic approach should be first choice because of similar operative complications and pelvic nodes, shorter hospital stay and less abdominal wall morbidity associated with lower risk to delay adjuvant radiotherapy.
authors.affiliation: Centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille Cedex. frederic.caquant@libertysurf.fr
authors.forename: Frédéric
authors.initials: F
authors.lastname: Caquant
authors.forename: Marie
authors.initials: M
authors.lastname: Mas-Calvet
authors.forename: Caroline
authors.initials: C
authors.lastname: Turbelin
authors.forename: Anne
authors.initials: A
authors.lastname: Lesoin
authors.forename: Daniele
authors.initials: D
authors.lastname: Lefebvre
authors.forename: Fabrice
authors.initials: F
authors.lastname: Narducci
authors.forename: Denis
authors.initials: D
authors.lastname: Querleu
authors.forename: Eric
authors.initials: E
authors.lastname: Leblanc
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D001835:Body Weight; D016889:Endometrial Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D009367:Neoplasm Staging; D009765:Obesity / Q000150:complications*; D012016:Reference Values; D016896:Treatment Outcome