title: Endometrial carcinoma: The perioperative and long-term outcomes of robotic surgery in the morbidly obese.
abstract: METHODS
  To evaluate surgical and pathologic outcomes of robotic assisted versus open hysterectomy for women with at least class II (BMI >35) and class III (BMI >40) obesity with endometrial cancer. Women with endometrial cancer and class II obesity, treated with open or robotic hysterectomy between 3/2005 and 3/2013 were eligible for inclusion in this retrospective cohort. Patients with class III obesity were reviewed both within the cohort of class II and as a separate subset. Data were collected on demographics, operative statistics, pathology, post-operative complications, and oncologic outcomes. Tests of significance used Chi-square, Fisher's exact test, t-test, and Wilcoxon rank-sum.
  
  
  RESULTS
  One hundred and thirty-six women with BMI >35 who underwent hysterectomy (56 robotic and 80 abdominal) were included. Patients undergoing robotic hysterectomies had fewer post-operative complications, shorter hospital stays, and lower blood loss compared to the abdominal group. A subset (83 of 136) with class III obesity had similar findings. Operative times, lymph node dissection rates, and lymph node yield (both pelvic and para-aortic) were similar between open and robotic surgery in both obesity classes. Oncologic outcomes and use of adjuvant treatment was not compromised.
  
  
  CONCLUSIONS
  Robotic hysterectomy is a safe and effective option for morbidly obese women with endometrial cancer. J. Surg. Oncol. 2016;114:884-887. © 2016 2016 Wiley Periodicals, Inc.
authors: Department of Obstetrics and Gynecology, The Medical College of Wisconsin, Milwaukee, Wisconsin.
authors: Shirley J
authors: SJ
authors: Hinshaw
authors: Department of Obstetrics and Gynecology, The Medical College of Wisconsin, Milwaukee, Wisconsin.
authors: Stephanie
authors: S
authors: Gunderson
authors: Division of Biostatistics, The Medical College of Wisconsin, Institute for Health and Society, Milwaukee, Wisconsin.
authors: Daniel
authors: D
authors: Eastwood
authors: Department of Obstetrics and Gynecology, The Medical College of Wisconsin, Milwaukee, Wisconsin. wbradley@mcw.edu.
authors: William H
authors: WH
authors: Bradley
mesh_terms: D000328:Adult; D000368:Aged; D016889:Endometrial Neoplasms / Q000150:complications / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D016896:Treatment Outcome
keywords: cancer of the endometrium; obesity; robotic surgical procedures