Efficacy and Safety of Robotic Surgery With Sentinel Lymph Node Navigation in Obese Patients With Endometrial Cancer: A Retrospective Study

摘要

OBJECTIVE: This study aimed to evaluate the feasibility and safety of robotic-assisted surgery combined with sentinel lymph node navigation surgery (SNNS) in obese patients with International Federation of Gynecology and Obstetrics stage IA endometrial cancer, comparing surgical and oncologic outcomes between obese and non-obese patients. METHODS: This retrospective study evaluated patients who underwent robotic-assisted hysterectomy, bilateral salpingo-oophorectomy, and SNNS at Kagoshima University Hospital between July 2018 and December 2024. The surgical outcomes, including operative time, console time, blood loss, and postoperative complications, of patients with a body mass index (BMI) of ≥ 30 kg/m² and ≥ 35 kg/m² were compared with those of their non-obese counterparts. RESULTS: Among the 294 patients evaluated, 39.5% had BMI ≥ 30 kg/m². Compared to non-obese patients, obese patients had significantly longer surgery start to roll-in time (P = 0.0026) and higher intraoperative blood loss (P = 0.018), whereas no significant differences were observed in operative time, console time, or postoperative complications. Patients with BMI ≥ 35 kg/m² had significantly longer operative time (P = 0.03) and surgery start to roll-in time (P = 0.0039) but showed no increased risk of postoperative complications. No cases required conversion to laparotomy. CONCLUSIONS: Robotic surgery with SNNS has minimal impact on the surgical outcomes of obese patients with endometrial cancer. Although obesity influences preoperative setup time and intraoperative blood loss, overall surgical safety is maintained. Thus, robotic surgery with SNNS is feasible and safe for these patients.