Feasibility and morbidity of total laparoscopic radical hysterectomy with or without pelvic limphadenectomy in obese women with stage I endometrial cancer.
OBJECTIVE
The aim of this study was to describe the feasibility and morbidity rates associated with total laparoscopic radical hysterectomy (TLRH) with or without pelvic lymphadenectomy for stage I endometrial cancer in obese women.


METHODS
Obese patients with stage I endometrial cancer who underwent total laparoscopic radical surgery at the Department of Obstetrics and Gynecology of San Gerardo Hospital were compared to nonobese patients. The same group of obese patients was compared with patients who underwent radical laparotomic surgery. Obesity was defined as a body mass index more than 30 kg/m(2).


RESULTS
Between September 2003 and September 2007, 75 women underwent TLRH. Median age was 54 years and median body mass index was 28 kg/m(2). Thirty-seven women were obese. There were no differences between nonobese and obese women in operative, time length of parametria and pelvic nodes removed and operative or late complications. Blood loss was significantly higher in obese patients. Comparing retrospectively laparoscopy and laparotomy in obese women treated in our center, laparotomy was associated with decreased operative time, but also with increased blood loss, transfusion rate, duration of hospitalization and frequency of post surgical complications.


CONCLUSIONS
Total laparoscopic radical hysterectomy (with pelvic lymphadenectomy) is a safe option in patients with endometrial cancer. Obesity is not a contraindication to perform a TRLH with no differences in surgical parameters between obese and nonobese population. TLRH show a significant decrease of complications compared to laparotomic radical surgery in obese women.
Pellegrino
Antonio
A
Division of Gynecologic Oncology, Clinica Ostetrica e Ginecologica, Ospedale San Gerardo, University of Milan-Bicocca, Monza, Milan, Italy.
Signorelli
Mauro
M
Fruscio
Robert
R
Villa
Annalisa
A
Buda
Alessandro
A
Beretta
Pietro
P
Garbi
Annalisa
A
Vitobello
Domenico
D
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D018269:Carcinoma, Endometrioid / Q000150:complications / Q000601:surgery*; D016889:Endometrial Neoplasms / Q000150:complications / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy; D008197:Lymph Node Excision / Q000379:methods; D008875:Middle Aged; D018200:Mixed Tumor, Mullerian / Q000150:complications / Q000601:surgery*; D009367:Neoplasm Staging; D009765:Obesity / Q000150:complications*; D010388:Pelvis / Q000601:surgery; D012189:Retrospective Studies