Surgical treatment of female patients with endometrial cancer and concomitant morbid obesity

This paper presents a literature review examining current approaches to the treatment of patients with endometrial cancer (EC) and concomitant morbid obesity. Excess body weight and associated hyperestrogenism are known to be the main risk factors for the development of the endometrioid type of EC. However, the treatment of these severely obese patients remains a pressing and controversial issue. Traditional laparoscopy, which has demonstrated high-quality and comparable oncological outcomes in patients with a body mass index <35 kg/m2, is characterized by an increase in the laparoconversion rate to 57% with a BMI >40 kg/m2, leading to an increased incidence of complications and a 33% increase in treatment costs. Robotic-assisted laparoscopic surgery creates all the necessary conditions for successful surgical treatment of such patients. Despite the high cost of robotic surgery, postoperative rehabilitation and recovery are much faster, which offsets overall costs (the difference in the cost of surgical treatment performed using laparoscopic, open, or robotic approaches was statistically insignificant). The obtained data suggest that preference should be given to robotic-assisted surgery in patients with endometriosis and concomitant morbid obesity.