Laparoscopic pelvic lymphadenectomy in patients with endometrial cancer and morbid obesity

Laparoscopic surgery in the morbidly obese woman can be technically challenging but it offers a minimal invasive approach for the treatment of endometrial cancer. We performed a retrospective analyze of 73 patients affected of stage I endometrial cancer. 28 patients were considered morbidly obese (BMI)> 40), while 45 patients were not (BMI < 40). All the patients were treated by total laparoscopic hysterectomy with bilateral salpingoophorectomy and pelvic or paraortic lymphadenectomy when feasible. Pelvic lymphadenectomy was performed in 17 (60,7%) of obese patients and 39 (86,6%) of non-obese group. Mean operative time did not differ between groups (166 vs 183 min). A bladder injury was observed in non-obese group, while no intraoperative complications occurred in the morbid obesity group. Hospital stay was similar between groups (91 vs 96 h). A more favorable histology was observed in the morbid obesity group (56% of G1 vs 32%). After 36 moths of follow up the recurrence rate was 0% in morbidly obese patients and 11% in non-obese group.