Trocar site hernia development in patients undergoing robotically assisted or standard laparoscopic staging surgery for endometrial cancer Journal Article

Authors: Cybulska, P.; Schiavone, M. B.; Sawyer, B.; Gardner, G. J.; Zivanovic, O.; Brown, C. L.; Jewell, E. L.; Sonoda, Y.; Barakat, R. R.; Abu-Rustum, N. R.; Leitao, M. M. Jr
Article Title: Trocar site hernia development in patients undergoing robotically assisted or standard laparoscopic staging surgery for endometrial cancer
Abstract: Objectives To compare the incidence and potential risk factors of trocar site hernia formation in women undergoing robotically assisted versus standard laparoscopic staging (RBT vs. LSC, respectively) for endometrial cancer. Methods We retrospectively identified all patients who underwent MIS staging for endometrial cancer at our institution from 01/09–12/12. Data collection involved the review of all operative notes, postoperative follow-up visit notes, and postoperative imaging reports. Appropriate statistical tests were used. Results We identified 760 eligible patients (LSC, 193; RBT, 567). The overall median age was 61 years (range, 33–90). The median BMI was 28.5 kg/m2 for LSC (range, 16.6–67.6) and 29.5 kg/m2 for RBT (range, 17.9–66) patients (p = 0.8). A trocar site hernia developed in 16 patients (2.1%)—5 (2.6%) of 193 LSC and 11 (1.9%) of 567 RBT patients (p = 0.6). Median time to hernia diagnosis was 13 months (range, 5–20.5) and 18 months (range, 3–49), respectively (p = 0.5). All hernias in the LSC cohort developed at the camera trocar site. In the RBT cohort, 10 developed at the camera trocar site and 1 at a lateral trocar site. Only BMI was associated with the development of hernias. A hernia was diagnosed in 7 (6.9%) of 101 patients with a BMI ≥ 40 kg/m2 compared with 9 (1.4%) of 659 with a BMI < 40 kg/m2 (p = 0.001). Conclusion MIS for endometrial cancer is associated with a low rate of trocar site hernia formation, with similar rates associated with RBT and standard LSC. Higher BMI is associated with the development of postoperative trocar site hernias. © 2017 Elsevier Inc.
Keywords: adult; aged; aged, 80 and over; middle aged; cancer surgery; retrospective studies; major clinical study; hypertension; comparative study; cancer staging; endometrial cancer; staging; endometrial neoplasms; neoplasm staging; laparoscopy; endometrium cancer; laparoscopic surgery; incidence; pathology; retrospective study; risk factor; risk assessment; postoperative complication; body mass; diabetes mellitus; hernia; comorbidity; ethnology; incisional hernia; procedures; laparoscopic staging; hernia, ventral; very elderly; humans; human; female; priority journal; article; robotic surgical procedure; statistics and numerical data; robotic surgical procedures; robot assisted surgery; trocar site; robotic staging; trocar site hernia
Journal Title: Gynecologic Oncology
Volume: 147
Issue: 2
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2017-11-01
Start Page: 371
End Page: 374
Language: English
DOI: 10.1016/j.ygyno.2017.09.005
PUBMED: 28947174
PROVIDER: scopus
PMCID: PMC5669832
Notes: Article -- Export Date: 1 December 2017 -- Source: Scopus
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MSK Authors
  1. Ginger J Gardner
    140 Gardner
  2. Elizabeth Jewell
    56 Jewell
  3. Richard R Barakat
    625 Barakat
  4. Carol Brown
    124 Brown
  5. Yukio Sonoda
    293 Sonoda
  6. Mario Leitao
    323 Leitao
  7. Oliver Zivanovic
    131 Zivanovic
  8. Brandon Thomas Sawyer
    1 Sawyer