Challenges on the morbidly obese endometrial cancer surgery: Laparotomy or laparoscopy, lymphadenectomy or no lymphadenectomy?
| Autor: | Sevtap Seyfettinoğlu, Mehmet Ali Vardar, Umran Kucukgoz-Gulec, Ahmet Güzel, İbrahim Ferhat Ürünsak, Ghanim Khatib |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Laparoscopic surgery medicine.medical_specialty medicine.medical_treatment Morbidly obese Postoperative Complications Laparotomy Outcome Assessment Health Care Humans Medicine Laparoscopy Aged Retrospective Studies Surgical approach medicine.diagnostic_test business.industry Endometrial cancer Obstetrics and Gynecology Middle Aged medicine.disease Endometrial Neoplasms Obesity Morbid Surgery Treatment Outcome Female Lymphadenectomy business Body mass index |
| Zdroj: | Ginekologia Polska. 91:453-459 |
| ISSN: | 2543-6767 0017-0011 |
| DOI: | 10.5603/gp.2020.0077 |
| Popis: | Objectives: A considerable proportion of endometrial cancer patients are morbidly obese. Management of these cases is a serious dilemma. The aim of this study was to investigate the relevance of laparoscopic route and omission of lymphadenectomy as morbidity-reducing strategies in this special population. Material and methods: Endometrial cancer patients’ archival records were retrospectively reviewed and cases with body mass index ≥ 40 kg/m2 were selected. A comparative evaluation of their characteristics and survival rates were performed. Firstly, according to the surgical approach; laparoscopy or laparotomy, and then regarding to performing lymphadenectomy or not. Results: There were 146 patients enrolled in this study. Whereas, significantly higher postoperative complications and longer hospital stays were determined in the laparotomy compared to laparoscopy groups. Five years disease-free and overall survival were not significantly different (83.6% vs 70.7%, p = 0.184 and 83.9% vs 86.6%, p = 0.571, respectively). On the other hand, operation length, postoperative hospitalization time, both intraoperative and postoperative complications were significantly lower in the non-lymphadenectomy compared to the lymphadenectomy groups. However, five-years disease-free and overall survival were not significantly different (77.3% vs 81.3%, p = 0.586 and 87.5% vs 78%, p = 0.479, respectively). Conclusions: Laparoscopic approach and omission of lymphadenectomy are worthy policies in the morbidly obese endometrial cancer patients. |
| Databáze: | OpenAIRE |
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