Operative treatment of adenocarcinoma of the endometrium in obese women

Prem, Konald A.; Mensheha, N. M.; McKelvey, J.L.

doi:10.1016/0002-9378(65)90100-6

Cited by 49 publications

(10 citation statements)

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“…The overall operative mortality has not been shown to be significantly increased in obese patients undergoing various surgical procedures. Trends however toward higher mortality rates in obese patients have been repeatedly noted (1)(2)(3)11). Small numbers of patients in all these studies may compromise the statistical results.…”

Section: Discussionmentioning

confidence: 99%

“…(1) patient survival; (2) graft survival; (3) initial graft function (defined as clearance of creatinine without dialysis by 1 week posttransplant); (4) duration of the operation; (5) need for reintubation postoperatively, after initial extubation; (6) admission to an intensive care unit; (7) colonic distension requiring either colonoscopic or surgical decompression; (8) wound complications including hematoma, infection, and dehiscence; (9) urinary-tract infections requiring antibiotic therapy; (10) duration of initial hospitalization; and (11) new-onset diabetes.…”

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confidence: 99%

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Obesity as a Risk Factor Following Cadaveric Renal Transplantation

et al. 1990

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Obesity has generally been thought to increase the risk of operative mortality and postoperative complications in surgical patients. No data examining obesity as a factor in cadaveric renal transplantation were available. We therefore matched obese patients undergoing cadaveric renal transplantation with nonobese control patients and retrospectively analyzed mortality, morbidity, and graft survival in each group. Patients were matched for age, sex, diabetes mellitus, PRA, graft number, cardiovascular disease, date of transplantation, and posttransplant immunosuppression. There were significant differences found in mortality (11% in obese vs. 2% in nonobese patients, P less than or equal to 0.01), immediate graft function (38% in obese vs. 64% in nonobese patients, P less than or equal to 0.01), 1-year graft survival (66% in obese vs. 84% in nonobese patients, P less than or equal to 0.05), and postoperative complications. Wound complications (20% vs. 2%, P less than or equal to 0.01), intensive-care-unit admissions (10% vs. 2%, P less than or equal to 0.01), reintubations (16% vs. 2%, P less than or equal to 0.03), and new-onset diabetes (12% vs. 0%, P less than or equal to 0.02) were all significantly more common in the obese group. These results suggest that an attempt at significant weight reduction is indicated in obese patients prior to renal transplantation.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Obesity as a Risk Factor Following Cadaveric Renal Transplantation

et al. 1990

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“…Obesity is widely considered a poor risk factor for surgical intervention. Obese patients undergoing cardiac, transplant, urologic, and gynecologic procedures have worse outcomes [5] , [6] , [7] , [8] . Recent data suggest that obesity is a risk factor for wound complications but not mortality [9] .…”

Section: Introductionmentioning

confidence: 99%

Influence of body mass index on outcomes in patients undergoing surgery for diverticular disease

Beresneva

Hall

2019

Surgery Open Science

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Background We hypothesized that increasing body mass index is a risk factor for surgical complications in surgery for diverticulitis. We assessed the relationship of body mass index and surgical complications following surgery for diverticular disease. Methods We used National Surgical Quality Improvement Program database from 2005 to 2015. Patients undergoing surgery for diverticular disease during that period were included and stratified into 9 groups based on their body mass index (< 18.5, 18.6–24.9, 25.0–29.9, 30.0–34.9, 35.0–39.9, 40.0–44.9, 45.0–49.9, 50.0–54.9, > 55). Outcomes of interest were complications of superficial surgical site infection, deep incisional surgical site infection, organ space surgical site infection, wound disruption complications, pneumonia, ventilator dependence > 48 hours, acute renal failure, myocardial infarction, return to operating room, and 30-day mortality. Results Morbidly obese patients had higher rates of diabetes, hypertension, and steroid use. They had higher American Society of Anesthesiologists classification and were more likely to have emergency and open cases. Interestingly, increased body mass index was inversely associated with age. Increasing body mass index was associated with worse outcomes including superficial surgical site infection, deep incisional surgical site infection, organ space surgical site infection, wound disruption complications, ventilator dependence > 48 hours, acute renal failure, and return to operating room. Risk of developing pneumonia didn't have similar correlation with body mass index. Overweight status had protective effect on mortality. No statistically significant differences in increased rates of myocardial infarction were noted. Underweight patients also developed worse outcomes. Conclusion Obesity is associated with a number of complications following surgery for diverticulitis. Elevated body mass index adds significant risk to procedures for diverticulitis and should be accounted for in risk stratification models. Patients should be counseled on weight reduction before undergoing elective surgery for diverticular disease.

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“…The same views were expressed by Strickland (1965) and Wade et al (1967). Others believe that the possible few extra cancer cures would probably be offset by the increased mortality and morbidity as many of the patients are old (Jordan, 1954;Randall, 1958;Alford et al, 1962;Beck and Latour, 1963;Prem et al, 1965;Morton, 1966;Ingiulla and Cosmi, 1968). Javert (1954) ascribed the poor prognosis in patients with pelvic node involvement to the fact that there was coexisting haematogenous spread.…”

Section: Deep Myometrial Infiltration Presentmentioning

confidence: 99%

The Case Against Wertheim's Hysterectomy in Endometrial Carcinoma

Mûelenaere

1973

BJOG

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Summary One hundred and four women with clinically operable endometrial cancer were treated by intrauterine radium followed by removal of the uterus and appendages without lymphadenectomy. Patients with recurrence confined to the pelvis were given external radiotherapy only. From review of these cases and study of the literature it is concluded that there is a high incidence of lymphatic metastases but these are not usually confined to the pelvis. Most of the deaths from the disease are due to distant lymphatic, transcoelomic or haematogenous spread without pelvic recurrence of the neoplasm. It is difficult to suggest a logical basis for selecting patients with endometrial cancer for Wertheim's hysterectomy with lymphadenectomy, an operation which does not offer a higher 5‐year survival rate in unselected patients. cology and Obstetrics, and Dr. Kenny, Superintendent, H. F. Verwoerd Hospital, for access to their records. The results of the present study formed part of an M.D. thesis for the University of Pretoria in 1972.

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Operative treatment of adenocarcinoma of the endometrium in obese women

Cited by 49 publications

References 0 publications

Obesity as a Risk Factor Following Cadaveric Renal Transplantation

Obesity as a Risk Factor Following Cadaveric Renal Transplantation

Influence of body mass index on outcomes in patients undergoing surgery for diverticular disease

The Case Against Wertheim's Hysterectomy in Endometrial Carcinoma

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