J Gynecol Oncol.  2011 Sep;22(3):168-176. 10.3802/jgo.2011.22.3.168.

Laparoscopic surgery for endometrial cancer: increasing body mass index does not impact postoperative complications

• Helm CW
• Arumugam C
• Gordinier
• Metzinger
• Pan J
• Rai SN

• KMID: 2055704
• DOI: http://doi.org/10.3802/jgo.2011.22.3.168

Abstract

OBJECTIVE
To determine the effect of body mass index on postoperative complications and the performance of lymph node dissection in women undergoing laparoscopy or laparotomy for endometrial cancer.
METHODS
Retrospective chart review of all patients undergoing surgery for endometrial cancer between 8/2004 and 12/2008. Complications graded and analyzed using Common Toxicity Criteria for Adverse Events ver. 4.03 classification.
RESULTS
168 women underwent surgery: laparoscopy n=65, laparotomy n=103. Overall median body mass index 36.2 (range, 18.1 to 72.7) with similar distributions for age, body mass index and performance of lymph node dissection between groups. Following laparoscopy vs. laparotomy the percent rate of overall complications 53.8:73.8 (p=0.01), grade > or =3 complications 9.2:34.0 (p<0.01), > or =3 wound complications 3.1:22.3 (p<0.01) and > or =3 wound infection 3.1:20.4 (p=0.01) were significantly lower after laparoscopy. In a logistic model there was no effect of body mass index (> or =36 and<36) on complications after laparoscopy in contrast to laparotomy. Para-aortic lymph node dissection was performed by laparoscopy 19/65 (29%): by laparotomy 34/103 (33%) p=0.61 and pelvic lymph node dissection by laparoscopy 21/65 (32.3%): by laparotomy 46/103 (44.7%) p=0.11. Logistic regression analysis revealed that for patients undergoing laparoscopy for stage I disease there was an inverse relationship between the performance of both para-aortic lymph node dissection and pelvic lymph node dissection and increasing body mass index (p=0.03 and p<0.01 respectively) in contrast to the laparotomy group where there was a trend only (p=0.09 and 0.05).
CONCLUSION
For patients undergoing laparoscopy, increasing body mass index did not impact postoperative complications but did influence the decision to perform lymph node dissection.

Keyword

Body mass index; Endometrial cancer; Laparoscopy; Laparotomy; Obesity

MeSH Terms

Body Mass Index
Endometrial Neoplasms
Female
Humans
Laparoscopy
Laparotomy
Logistic Models
Lymph Node Excision
Obesity
Postoperative Complications
Retrospective Studies
Wound Infection

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