title: Relationship between body mass index and robotic surgery outcomes of women diagnosed with endometrial cancer.
abstract: OBJECTIVE
  This is a prospective evaluation of the outcome of minimal invasive surgery using robotics in function of the body mass index (BMI) of patients.
  
  
  METHODS
  This is a prospective cohort study of consecutive women undergoing surgery for endometrial cancer at a tertiary care facility since the initiation of a robotic program in December 2007. Surgical and personal outcome variables as well as quality of life and postoperative recovery were assessed using a combination of objective and subjective/self-report questionnaires. Women were divided into 3 groups based on their BMI. Comparative analyses among nonobese (n = 52), obese (n = 33) and morbidly obese (n = 23) women were performed on the outcome measures after surgery.
  
  
  RESULTS
  The mean BMI and the range in each of the BMI categories was 25 kg/m² (18.7-29.4 kg/m²), 34 kg/m² (30.1-38.4 kg/m²), and 46 kg/m² (40.0-58.8 kg/m²). Women with higher BMI tended to be more frequently affected with comorbidities such as diabetes (15.4%, 26.0%, and 27.3%, respectively; P = 0.32) and hypertension (55.8%, 69.6%, and 69.7%, respectively; P = 0.19). Despite these differences, surgical console time (P = 0.20), major postoperative complications (P = 0.52), overall wound complications (P = 0.18), and median length of hospitalization in days (P = 0.17) were not statistically different among the 3 groups. Only 5.6% of women needed a mini laparotomy all of which were performed for the removal of their enlarged uterus, which could not be delivered safely via the vagina, at the end of the surgical procedure. There was no increased conversion to laparotomy due to increased BMI. Women in all 3 groups reported rapid resumption of hygiene regimens and chores, little need for narcotic analgesia, and high satisfaction with the procedure.
  
  
  CONCLUSIONS
  Obese and morbidly obese patients with endometrial cancer are also good candidates for robotic surgery. These women benefit considerably from minimal invasive surgery and have little perioperative complications.
authors.affiliation: Division of Gynecologic Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
authors.forename: Susie
authors.initials: S
authors.lastname: Lau
authors.forename: Karen
authors.initials: K
authors.lastname: Buzaglo
authors.forename: Zvi
authors.initials: Z
authors.lastname: Vaknin
authors.forename: Sonya
authors.initials: S
authors.lastname: Brin
authors.forename: Rebecca
authors.initials: R
authors.lastname: Kaufer
authors.forename: Nancy
authors.initials: N
authors.lastname: Drummond
authors.forename: Iris
authors.initials: I
authors.lastname: Gourdji
authors.forename: Sylvie
authors.initials: S
authors.lastname: Aubin
authors.forename: Zeev
authors.initials: Z
authors.lastname: Rosberger
authors.forename: Walter H
authors.initials: WH
authors.lastname: Gotlieb
mesh_terms: D000368:Aged; D015992:Body Mass Index; D002277:Carcinoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016889:Endometrial Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D056865:Ideal Body Weight / Q000502:physiology; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000601:surgery; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery; D059035:Perioperative Period / Q000009:adverse effects; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology