Giacomo Corrado1, Enrico Vizza2, Vito Cela3, Liliana Mereu4, Stefano Bogliolo5, Francesco Legge6, Francesca Ciccarone7, Emanuela Mancini2, Valerio Gallotta7, Ermelinda Baiocco2, Giorgia Monterossi7, Maria Teresa Perri7, Ashanti Zampa2, Tina Pasciuto7, Giovanni Scambia8. 1. Department of Women and Children Health, Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy. Electronic address: giacomo.corrado@policlinicogemelli.it. 2. Department of Experimental Clinical Oncology, Gynecologic Oncology Unit, IRCCS - Regina Elena National Cancer Institute, Rome, Italy. 3. Department of Obstetrics and Gynecology, University of Pisa, Pisa, Italy. 4. Obstetrics and Gynecological Department, Santa Chiara Hospital, Trento, Italy. 5. Department of Obstetrics and Gynecology, IRCCS-Fondazione Policlinico San Matteo and University of Pavia, Italy. 6. Department of Obstetrics and Gynecology, Division of Gynecology, "F. Miulli" General Hospital, Acquaviva delle Fonti, Bari, Italy. 7. Department of Women and Children Health, Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy. 8. Department of Women and Children Health, Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy; Department of Women and Children Health, Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Abstract
OBJECTIVE: The aim of this study was to evaluate the surgical and oncological outcome of robotic surgical staging with hysterectomy (RH) plus or less pelvic and aortic lymphadenectomy, compared to the same procedures performed by laparoscopic surgery (LH) in obese patients (BMI≥30 kg/m2) with endometrial cancer. MATERIAL AND METHODS: From October 2001 to April 2017, obese patients (BMI > 30 kg/m2) with primary, histologically confirmed endometrial carcinoma who underwent LH or RH using the Da Vinci Si or Xi Surgical System® (Intuitive Surgical Inc®, 1266 Kifer Road, Building 101 Sunnyvale, CA) were eligible for the study. RESULTS: We identified 655 women with endometrial cancer and BMI >30 kg/m2. Out of 655 patients, 249 (38%) underwent RH and 406 (62%) underwent LH plus or less pelvic and aortic lymphadenectomy. Our study showed that, compared to the 406 patients treated in LPS, 249 patients treated in robotics have a statistically significant difference in terms of increased operating time and a decreased conversion rate. In addition, the rate of pelvic lymphadenectomies in robotic surgeries is twice the one reported in LPS surgeries. Furthermore, a reduction in hospital stay was observed in the robotic group. We observed that the oncological outcomes do not vary according to the surgical approach and BMI variation. CONCLUSIONS: robotic surgery in severely obese women with endometrial cancer is feasible, safe, and reproducible and could be a valid alternative to laparoscopy in the treatment of these patients. Prospective studies could confirm our results.
OBJECTIVE: The aim of this study was to evaluate the surgical and oncological outcome of robotic surgical staging with hysterectomy (RH) plus or less pelvic and aortic lymphadenectomy, compared to the same procedures performed by laparoscopic surgery (LH) in obesepatients (BMI≥30 kg/m2) with endometrial cancer. MATERIAL AND METHODS: From October 2001 to April 2017, obesepatients (BMI > 30 kg/m2) with primary, histologically confirmed endometrial carcinoma who underwent LH or RH using the Da Vinci Si or Xi Surgical System® (Intuitive Surgical Inc®, 1266 Kifer Road, Building 101 Sunnyvale, CA) were eligible for the study. RESULTS: We identified 655 women with endometrial cancer and BMI >30 kg/m2. Out of 655 patients, 249 (38%) underwent RH and 406 (62%) underwent LH plus or less pelvic and aortic lymphadenectomy. Our study showed that, compared to the 406 patients treated in LPS, 249 patients treated in robotics have a statistically significant difference in terms of increased operating time and a decreased conversion rate. In addition, the rate of pelvic lymphadenectomies in robotic surgeries is twice the one reported in LPS surgeries. Furthermore, a reduction in hospital stay was observed in the robotic group. We observed that the oncological outcomes do not vary according to the surgical approach and BMI variation. CONCLUSIONS: robotic surgery in severely obesewomen with endometrial cancer is feasible, safe, and reproducible and could be a valid alternative to laparoscopy in the treatment of these patients. Prospective studies could confirm our results.
Authors: Slavcho T Tomov; Grigor A Gorchev; Desislava K Kiprova; Aleksandar D Lyubenov; Nadezhda H Hinkova; Vesela D Tomova; Zornitsa V Gorcheva; Sarfraz Ahmad Journal: J Robot Surg Date: 2022-02-10
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Authors: Antonio Raffone; Antonio Travaglino; Diego Raimondo; Dominga Boccia; Martino Vetrella; Paolo Verrazzo; Marcello Granata; Paolo Casadio; Luigi Insabato; Antonio Mollo; Renato Seracchioli Journal: Int J Gynaecol Obstet Date: 2021-06-19 Impact factor: 4.447