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Objective.Panniculectomy has been used to facilitate pelvic surgery i n obese w omen. The goal of this study was to determine the effect of panniculectomy on st aging adequacy and lymph node yield in obese women with endometrial carcinoma un dergoing staging laparotomy. Methods. A retrospective review of patients with endometrial neoplasms who underwent pann iculectomy at the time of hysterectomy was performed. For each subject, two cont rol patients were matched by body mass index (BMI). Results. Twenty-seven endom etrial cancer patients who underwent panniculectomy at the time of staging were identified. Panniculectomy was successfully performed in all 27 patients. While the mean number of pelvic nodes was statistically similar between the two groups (16.2 vs. 13.7)-(P = 0.199), the paraaortic node count was higher in patients who underwent panniculectomy (4.3 vs. 2.9) (P = 0.032). A paraaortic node dissec tion was not feasible in 3 (11.1%) of the panniculectomy patients and in 11 (20 .4%) of the controls (P = 0.365). There were no differences in intraoperative o r postoperative complications or in survival between the two groups. Conclusion. Among obese women with endometrial cancer, panniculectomy is well tolerated, fe asible, and associated with acceptable morbidity. While the clinical significanc e of an increased paraaortic node count is uncertain, our findings suggest that panniculectomy may enhance operative exposure and facilitate endometrial cancer staging.
Objective. Panniculectomy has been used to facilitate pelvic surgery in obese w omen. The goal of this study was to determine the effect of panniculectomy on stacy adequacy and lymph node yield in obese women with endometrial carcinoma un dergoing staging laparotomy. Methods. A retrospective review of patients with endometrial neoplasms who underwent pann iculectomy at the time of hysterectomy was performed. Each each subject, two cont rol patients were matched by body mass index (BMI). Results. Twenty-seven endom etrial cancer patients who underwent panniculectomy at the Panniculectomy was successfully performed in all 27 patients. While the mean number of pelvic nodes was statistically similar between the two groups (16.2 vs. 13.7) - (P = 0.199), the paraaortic node count was higher in patients who underwent panniculectomy (4.3 vs. 2.9) (P = 0.032). A paraaortic node dissection was not feasible in 3 (11.1%) of the panniculectomy patients and in 11 (2 0. 4%) of the controls (P = 0.365). There were no differences in intraoperative or postoperative complications or in survival between the two groups. Conclusion. Among obese women with endometrial cancer, panniculectomy is well tolerated, fe asible, and associated with the acceptable morbidity. While the clinical significanc e of an increased paraaortic node count is uncertain, our findings suggest that panniculectomy may enhance operative exposure and facilitate endometrial cancer staging.