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Robotic Hysterectomy for Endometrial Cancer in Obese Patients With Comorbidities: Evaluating Postoperative Complications

Authors :
David E. Cohn
David M OʼMalley
Jeffrey M. Fowler
Maggie A. Rosen
Margaret I. Liang
Georgia A. McCann
Ritu Salani
Floor J. Backes
A. Clements
Source :
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 25(7)
Publication Year :
2015

Abstract

ObjectivesThe objective of this study is to determine (1) if there is a relationship between increasing body mass index (BMI) and postoperative complications in patients undergoing robotic hysterectomy for endometrial cancer and (2) if there are additional patient characteristics, specifically preoperative comorbidities, which increase the risk of postoperative complicationMethodsA retrospective chart review was conducted on women who underwent a robotic staging surgery for endometrial cancer from 2006 to 2012. Basic demographics and preoperative and postoperative complications were extracted from the medical records. Obesity was divided into 4 categories, and complication rates were compared across these subgroups. Patients were also divided by the number of comorbidities and compared.ResultsThe cohort included 543 patients. The BMI ranged from 17.3 to 69.5 kg/m2. Three hundred eighty patients (70%) were obese (BMI >30 kg.m2). One hundred ninety patients (35%) had no comorbidities other than obesity, and 180 patients (33%) had only 1 comorbidity other than obesity (Table 1).Postoperative complications occurred in 102 (18.7%) of the patients. Severe postoperative complications, including intensive care unit admission, reintubation, reoperation, and perioperative death, occurred in 14 patients (2.6%). Of the nonobese patients, 27 (16.5%) had postoperative complications; of the obese patients, 75 (19.7%) had a complication (P = 0.38). In patients with no comorbidities, 16.3% had a complication; 18% of patients with 1 to 2 comorbidities had a complication, and 28% of patients with 3 or more comorbidities had a complication (P = 0.08).ConclusionsThe postoperative complication rate based on BMI or number of comorbidities was not statistically significant, but patients with greater number of comorbidities had an increased rate of postoperative complications. Patients with certain comorbidities, cardiac and renal specifically, had the highest rates of postoperative complications.

Details

ISSN :
15251438
Volume :
25
Issue :
7
Database :
OpenAIRE
Journal :
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
Accession number :
edsair.doi.dedup.....c13cfa4f1633070481d1307e2a336688