肥満合併子宮体癌患者に対する腹腔鏡下子宮悪性腫瘍手術の後方視的検討

抄録

Objective: Laparoscopic surgery is recognized as a useful and minimally invasive strategy for treating uterine corpus cancer. Although obesity is a risk factor for uterine corpus cancer, laparoscopic surgery for obese patients with uterine corpus cancer is sometimes avoided owing to the associated complications and technical difficulties. The aim of this study was to evaluate the feasibility of laparoscopic surgery for obese patients with uterine corpus cancer.

Methods: The operation time, amount of blood loss, number of removed lymph nodes, and length of hospital stay were assessed retrospectively according to the patients' body mass index (BMI) values and the surgical methodology (open or laparoscopic surgery).

Results: Operation times for pelvic lymphadenectomy were not significantly different between the obese and non-obese groups. The operation times for cases involving pelvic and para-aortic lymphadenectomy were significantly longer in obese patients than in non-obese patients (p=0.0327 for laparoscopic surgery cases and p=0.0075 for open surgery cases). Although the amount of blood loss was significantly greater for obese patients than for non-obese patients in cases involving laparoscopic pelvic lymphadenectomy (p=0.0158), the average amount of blood loss was 151.4 g, which was not clinically important and was a significantly smaller amount than that in open surgery (p<0.0001). The number of resected lymph nodes and length of hospital stay were not significantly different between cases involving obese and non-obese patients. There were no recurrent cases in the laparoscopic group.

Conclusion: These findings suggest that laparoscopic surgery is feasible as a minimally invasive treatment for obese patients with uterine corpus cancer.