title: A comparison of open surgery, robotic-assisted surgery and conventional laparoscopic surgery in the treatment of morbidly obese endometrial cancer patients.
abstract: OBJECTIVE
  The intent of this retrospective study was to assess the operative outcomes of morbidly obese endometrial cancer patients who were treated with either open surgery (OS) or a minimally invasive procedure.
  
  
  METHODS
  Morbidly obese (body mass index [BMI] > 40 kg/m(2)) patients with endometrial cancer who underwent OS, robotic-assisted laparoscopic surgery (RS), or conventional laparoscopic surgery (LS) were eligible. We sought to discern any outcome differences with regard to operative time, perioperative complications, and hospital stay.
  
  
  RESULTS
  Sixteen patients were treated with LS (BMI = 47.9 kg/m(2)), 13 were managed via RS (BMI = 51.2 kg/m(2)), and 24 underwent OS (BMI = 53.7 kg/m(2)). The OS (1.35 hours) patients had a significantly shorter operative duration than the LS (1.82 hours) and RS (2.78 hours) patients (P < .001); blood loss was greater in the OS (250 mL) group in comparison with the RS (100 mL) and LS (175 mL) patients (P = .002). Moreover, the OS (4 days) subjects had a significantly longer hospital stay than the LS (2 days) and RS (2 days) patients (P = .002).
  
  
  CONCLUSIONS
  In the present study, we ascertained that minimally invasive surgery was associated with longer operative times but lower rates of blood loss and shorter hospital stay duration compared with treatment comprising an open procedure.
authors.affiliation: Gynecologic Oncology Associates, Newport Beach, CA USA.
authors.forename: Alberto A
authors.initials: AA
authors.lastname: Mendivil
authors.affiliation: Gynecologic Oncology Associates, Newport Beach, CA USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Rettenmaier
authors.affiliation: Gynecologic Oncology Associates, Newport Beach, CA USA.
authors.forename: Lisa N
authors.initials: LN
authors.lastname: Abaid
authors.affiliation: Gynecologic Oncology Associates, Newport Beach, CA USA.
authors.forename: John V
authors.initials: JV
authors.lastname: Brown
authors.affiliation: Gynecologic Oncology Associates, Newport Beach, CA USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Micha
authors.affiliation: Women's Cancer Research Foundation, Newport Beach, CA, USA.
authors.forename: Katrina L
authors.initials: KL
authors.lastname: Lopez
authors.affiliation: Gynecologic Oncology Associates, Newport Beach, CA USA.
authors.forename: Bram H
authors.initials: BH
authors.lastname: Goldstein
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016889:Endometrial Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008875:Middle Aged; D009017:Morbidity; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery; D061646:Operative Time; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures
keywords: Endometrial cancer; Minimally invasive surgery; Morbid obesity; Open surgery
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