Early endometrial carcinoma therapy in morbid obesity: A retrospective study comparing open and laparoscopic.
OBJECTIVE
The present study sought to explore the therapeutic outcome of laparoscopic surgery for the endometrial cancer patients with morbidly obese in china.


METHODS
The morbidly obese patients with clinical stage I or II endometrial cancer received laparoscopic surgery (LS) at the Obstetrics and Gynecology centers of PLA general hospital between November 2012 and November 2014. The clinical outcomes of these surgeries were compared with a historical cohort of similar morbidly obese patients who had received the open surgery (OS). In the present study, the morbidly obesity was defined as the body mass index was bigger than 40 kg/m(2). The basic characteristics of the involved patients, the therapeutic effects of the surgery, as well as the incidence of perioperative complications were systematically compared between the two groups.


RESULTS
Totally 120 patients were included in the present study (respectively 60 patients in the LS group and the OS group). There was no statistical difference between the LS group and the OS group in terms of patient age or BMI. However, the incidence of intraoperative complication in the LS group was significantly lower than that in the OS group (5.0% vs. 16.7%; P = 0.04. Moreover, the incidence of postoperative complication in the OS group was higher than that in the LS group (20.0% vs.6.7%; P = 0.03). The length of hospital stay in the LS group was longer than that in the OS group (6 vs.11 days; P = 0.02). Furthermore, the rates of (pelvic) lymph node dissection and para-aortic node dissection in the LS group were not significantly different from the OS group.


CONCLUSIONS
LS is verified to be a safe and rational therapeutic strategy for the endometrial cancer patients with morbidly obese. The incidence of perioperative complications is significantly lower in comparison with the OS.
Department of Obstetrics and Gynecology, PLA General Hospital, Beijing, PR China; Department of Obstetrics and Gynecology, PLA 309 Hospital, Beijing, PR China.
Zhengxian
Z
Cheng
Department of Obstetrics and Gynecology, PLA 309 Hospital, Beijing, PR China.
Xiaoqing
X
He
Department of Obstetrics and Gynecology, PLA 309 Hospital, Beijing, PR China.
Aihua
A
Zhao
Department of Obstetrics and Gynecology, PLA 309 Hospital, Beijing, PR China.
Qiaoyu
Q
Zhang
Department of Obstetrics and Gynecology, PLA General Hospital, Beijing, PR China. Electronic address: liyali301@aliyun.com.
Yali
Y
Li
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D016889:Endometrial Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D007902:Length of Stay / Q000706:statistics & numerical data; D008197:Lymph Node Excision; D008875:Middle Aged; D009017:Morbidity; D009367:Neoplasm Staging; D009767:Obesity, Morbid / Q000150:complications*; D011183:Postoperative Complications; D012189:Retrospective Studies; D055502:Secondary Prevention; D016896:Treatment Outcome
Endometrial cancer; Laparoscopic surgery; Morbid obesity