TY - JOUR
T1 - Feasibility and Surgical Outcome in Obese Versus Nonobese Patients Undergoing Laparoendoscopic Single-site Hysterectomy
T2 - A Multicenter Case-control Study
AU - Fanfani, Francesco
AU - Boruta, David M.
AU - Fader, Amanda N.
AU - Vizza, Enrico
AU - Growdon, Withfiel B.
AU - Kushnir, Cristina L.
AU - Corrado, Giacomo
AU - Scambia, Giovanni
AU - Turco, Luigi C.
AU - Fagotti, Anna
N1 - Publisher Copyright:
© 2015 AAGL.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Objective: To assess the feasibility and perioperative outcomes of laparoendoscopic single-site (LESS) hysterectomy in obese and nonobese women. Design: A multicentric retrospective case-control study (Canadian Task Force II-2). Setting: Catholic University of the Sacred Heart and National Cancer Institute "Regina Elena" (Rome, Italy), Massachusetts General Hospital (Boston, MD), and Johns Hopkins Hospital (Baltimore, MD). Patients: From July 2009 to April 2013, 120 women underwent LESS hysterectomy. Five women (8%) were excluded from the analysis. The remaining 115 women were divided into 2 groups: obese (n=43, body mass index [BMI] <30kg/m2) and nonobese (n=72, BMI <30kg/m2). Interventions: Total LESS hysterectomies for malignant and premalignant uterine disease or at least for prophylactic intent were performed. Measurements and Main Results: No statistical differences regarding perioperative outcomes were observed between the 2 groups. Conversion to standard laparoscopy occurred in 2 obese (5%) and 2 (5%) nonobese women (p=62). Conversion to laparotomy occurred in 1 obese (2.3%) and 3 (4.2%) nonobese women (p=212). The median operative time was 115minutes (range, 48-300minutes) in obese and 114minutes (range, 55-342minutes) in nonobese women (p=787). The intraoperative complication rate was 11.6% and 9.6% in obese and nonobese women, respectively (p=712). The early postoperative complication rate was 6.9% in obese and 4.1% in nonobese women (p=516). Conclusion: Despite the fact that the present analysis was performed in a relatively small group of patients, this study suggests that obesity (BMI <30) does not preclude successful completion of total LESS hysterectomy. Further prospective studies are required to confirm these preliminary data and to clarify potential advantages and disadvantages of LESS in obese women.
AB - Objective: To assess the feasibility and perioperative outcomes of laparoendoscopic single-site (LESS) hysterectomy in obese and nonobese women. Design: A multicentric retrospective case-control study (Canadian Task Force II-2). Setting: Catholic University of the Sacred Heart and National Cancer Institute "Regina Elena" (Rome, Italy), Massachusetts General Hospital (Boston, MD), and Johns Hopkins Hospital (Baltimore, MD). Patients: From July 2009 to April 2013, 120 women underwent LESS hysterectomy. Five women (8%) were excluded from the analysis. The remaining 115 women were divided into 2 groups: obese (n=43, body mass index [BMI] <30kg/m2) and nonobese (n=72, BMI <30kg/m2). Interventions: Total LESS hysterectomies for malignant and premalignant uterine disease or at least for prophylactic intent were performed. Measurements and Main Results: No statistical differences regarding perioperative outcomes were observed between the 2 groups. Conversion to standard laparoscopy occurred in 2 obese (5%) and 2 (5%) nonobese women (p=62). Conversion to laparotomy occurred in 1 obese (2.3%) and 3 (4.2%) nonobese women (p=212). The median operative time was 115minutes (range, 48-300minutes) in obese and 114minutes (range, 55-342minutes) in nonobese women (p=787). The intraoperative complication rate was 11.6% and 9.6% in obese and nonobese women, respectively (p=712). The early postoperative complication rate was 6.9% in obese and 4.1% in nonobese women (p=516). Conclusion: Despite the fact that the present analysis was performed in a relatively small group of patients, this study suggests that obesity (BMI <30) does not preclude successful completion of total LESS hysterectomy. Further prospective studies are required to confirm these preliminary data and to clarify potential advantages and disadvantages of LESS in obese women.
KW - Hysterectomy
KW - Laparoendoscopic single-site surgery
KW - Laparoscopy
KW - Obesity
KW - Single site
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U2 - 10.1016/j.jmig.2014.12.008
DO - 10.1016/j.jmig.2014.12.008
M3 - Article
C2 - 25510981
AN - SCOPUS:84924516829
SN - 1553-4650
VL - 22
SP - 456
EP - 461
JO - Journal of Minimally Invasive Gynecology
JF - Journal of Minimally Invasive Gynecology
IS - 3
ER -