Cunningham Mary J, Dorzin Esther, Nguyen Loan, Anderson Elizabeth, Bunn W Douglas
Department of Obstetrics and Gynecology, SUNY Upstate Medical University, Syracuse, NY, USA.
GYN Oncology of CNY, PC, 475 Irving Ave, Suite 204, Syracuse, NY, 13210, USA.
J Robot Surg. 2015 Dec;9(4):339-45. doi: 10.1007/s11701-015-0538-8. Epub 2015 Nov 4.
A retrospective cohort study was performed to evaluate the relationship of BMI to conversion rate in patients undergoing robotic surgery for endometrial cancer. Secondary outcomes were operative times, number of lymph nodes retrieved, and complications. Women with endometrial cancer scheduled for robotic surgery from September 2008 to September 2012 were included. Women were divided into three groups based on BMI, and conversion rates to laparotomy were compared. Descriptive and comparative analyses were performed among non-obese, obese, and morbidly obese women who completed robotic surgery. 298 women were scheduled for robotic surgery for endometrial carcinoma: 87 non-obese (BMI 19-29, μ 25.23), 110 obese (BMI 30-39, μ 34.21), and 101 morbidly obese (BMI 40-71, μ 47.38). Conversion to laparotomy occurred in 18 patients (6%), with no difference in conversion rate between BMI categories. Direct comparison between converted and completed robotic patients showed no significant differences in preoperative characteristics, except that patients who required conversion had a higher number of previous abdominal surgeries. Patients completing robotic surgery underwent node dissections at similar rates in all three BMI categories. Operating room time, but not surgical time, was increased in morbidly obese patients. There were no significant differences in complications, performance of lymphadenectomy, or lymph node yields between BMI categories. Increase in BMI was not associated with an increase in rate of conversion to laparotomy or complication rate in patients undergoing robotic surgery for endometrial carcinoma. Node dissections were pathologically equivalent between BMI categories.
进行了一项回顾性队列研究，以评估子宫内膜癌机器人手术患者的体重指数（BMI）与中转率之间的关系。次要结局指标为手术时间、获取的淋巴结数量和并发症。纳入了2008年9月至2012年9月计划进行机器人手术的子宫内膜癌女性患者。根据BMI将女性分为三组，并比较中转开腹手术的比率。对完成机器人手术的非肥胖、肥胖和病态肥胖女性进行描述性和比较性分析。298名女性计划进行子宫内膜癌机器人手术：87名非肥胖患者（BMI 19 - 29，平均25.23），110名肥胖患者（BMI 30 - 39，平均34.21），101名病态肥胖患者（BMI 40 - 71，平均47.38）。18例患者（6%）中转开腹手术，BMI类别之间的中转率无差异。中转手术患者与完成机器人手术患者的直接比较显示，术前特征无显著差异，只是需要中转手术的患者既往腹部手术次数较多。所有三个BMI类别中，完成机器人手术的患者进行淋巴结清扫的比率相似。病态肥胖患者的手术室时间增加，但手术时间未增加。BMI类别之间在并发症、淋巴结切除术的实施情况或淋巴结获取数量方面无显著差异。BMI增加与子宫内膜癌机器人手术患者中转开腹手术率或并发症率的增加无关。BMI类别之间淋巴结清扫的病理结果相当。
