Double intervention against endometrial cancer and obesity: is it possible without increasing risks?

Fighting cancer and at the same time one of its most well-known risk factors, obesity. It happens in Bologna, at the Policlinico di Sant'Orsola Irccs (among the centers of excellence for gynecology ), where some women with severe obesity and endometrial cancer are offered the possibility of a double simultaneous surgical intervention. The results of the experiences accumulated so far demonstrate that the strategy is not only feasible but does not involve additional risks. The details have been reported on the pages of Surgical Endoscopy .

The Robot Surgeon Against Cancer and Obesity

“The case study is still limited, but already significant, unfortunately it is not always easy to convince patients with severe obesity to undergo the combined gynecological and sleeve gastrectomy surgery”, explained Myriam Perrone , surgeon of the Oncological Gynecology operating unit, one of the authors of the study. In fact, of the 13 patients enrolled, only five chose to undergo the double procedure, a total hysterectomy for endometrial cancer and bariatric surgery.

The operations were performed using the Da Vinci surgical robot, which is particularly suitable for these conditions, Perrone continues: “Operating on patients with severe obesity (BMI greater than 35 kg/m2) in laparoscopy is very difficult and tiring, because most of the fat is located right in the area of ​​the operation. The use of the robot allows for better surgical vision and maneuverability during the operation and reduces the risk of complications and, why not, also the fatigue of the surgeon”.

Double intervention without increasing risks

On average, double interventions did last longer than single interventions, that is, those performed only against the tumor, but this did not lead to an increase in complications, or a lengthening of hospital stays or the need for transfusions or a greater use of intensive care, the experts explain.

Although the sample analyzed was very small, the double session in the operating room was successful in 80% of cases. As expected, moreover, the patients who had also undergone bariatric surgery in the following months managed to lose much more weight than those who had only undergone hysterectomy. A fact that, although obvious, is rather important. The same clinicians underlined it only a few months ago in the pages of the International Journal Gynecological Cancer, recalling how bariatric surgery offers the possibility of losing weight quickly and significantly, in the face of repeated attempts at weight control.