Value of robotic surgery in endometrial cancer by body mass index

Objective To compare perioperative outcomes and complications in robotically assisted laparoscopy (RAL) and standard laparoscopy (SLP) approaches in the treatment of endometrial cancer by body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters). Methods A comparative study was carried out of women treated for endometrial cancer at the Hospital Clinico San Carlos from January 2012 to December 2016: 133 patients were operated by RAL and 101 by SLP. Demographic characteristics of the patients, perioperative outcomes and complications were compared in both approaches. Results Hospital stay was significantly lower in patients with BMI <= 30 operated with RAL (2 days RAL vs 4 days SLP;P=0.002). Estimated blood loss was significantly lower in the group with BMI<25 (60 mL RAL vs 100 mL SLP;P=0.004) and in the group with BMI >= 30 (87.5 mL RAL vs 180 SLP;P=0.003) operated with RAL. RAL significantly reduced the conversion rate in patients with BMI >= 30 (2 [3.4%] patients RAL vs 6 [27.3%] patients SLP;P=0.004). Conclusions RAL has demonstrated advantages in treating obese women with endometrial cancer by reducing blood loss and conversion to laparotomy.