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子宫内膜癌的腹腔镜手术分期:肥胖是否会影响其可行性及围手术期结局?

Laparoscopic surgical staging of endometrial cancer: does obesity influence feasibility and perioperative outcome?

作者信息

Litta P, Fabris A M, Breda E, Bartolucci C, Conte L, Saccardi C, Nappi L

机构信息

Department of Women's and Children's Health, Obstetrics and Gynecology Clinic, University of Padua, Padua, Italy.

出版信息

Eur J Gynaecol Oncol. 2013;34(3):231-3.

Abstract

AIM

Laparoscopic treatment of early-stage endometrial cancer is the gold standard to reduce perioperative morbidity. Obesity is a well-known risk factor for endometrial cancer and anesthesiological and surgical complications. The authors' aim was to examine the effect of body mass index (BMI) on perioperative parameters and complications in laparoscopically-treated patients with endometrial cancer.

MATERIALS AND METHODS

A consecutive series of patients affected by endometrial cancer and their demographic and clinicopathological data were collected. Patients were divided in 41 non-obese (BMI <or= 29.9) and 34 obese (BMI >or= 30) groups. All patients had been preoperatively evaluated with hysteroscopic procedures and toraco-abdominal computed tomography (CT) and had been submitted to laparoscopic radical hysterectomy according to Querleu-Morrow, pelvic lymphadenectomy, peritoneal washing, and bilateral adnexectomy.

RESULTS

There was no statistically significant difference in blood loss, number of lymph nodes removed, and hospital stay between the groups, but there was a trend towards a lengthening of surgical time in the obese women. There were no major intraoperative and postoperative complications.

DISCUSSION

This study demonstrates that laparoscopic approach is feasible and safe in obese women evaluating the anesthesiological risk.

摘要

目的

腹腔镜治疗早期子宫内膜癌是降低围手术期发病率的金标准。肥胖是子宫内膜癌以及麻醉和手术并发症的一个众所周知的风险因素。作者的目的是研究体重指数(BMI)对接受腹腔镜治疗的子宫内膜癌患者围手术期参数和并发症的影响。

材料与方法

收集一系列连续的子宫内膜癌患者及其人口统计学和临床病理数据。患者被分为41名非肥胖(BMI≤29.9)和34名肥胖(BMI≥30)组。所有患者术前均接受了宫腔镜检查和胸腹计算机断层扫描(CT)评估,并根据Querleu-Morrow法接受了腹腔镜根治性子宫切除术、盆腔淋巴结清扫术、腹腔冲洗和双侧附件切除术。

结果

两组之间在失血量、切除淋巴结数量和住院时间方面无统计学显著差异,但肥胖女性的手术时间有延长趋势。无重大术中及术后并发症。

讨论

本研究表明,对于评估麻醉风险的肥胖女性,腹腔镜手术方法是可行且安全的。

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