Arch Gynecol Obstet DOI 10.1007/s00404-008-0790-5 123 ORIGINAL ARTICLE Feasibility and morbidity of total laparoscopic radical hysterectomy with or without pelvic limphadenectomy in obese women with stage I endometrial cancer Antonio Pellegrino · Mauro Signorelli · Robert Fruscio · Annalisa Villa · Alessandro Buda · Pietro Beretta · Annalisa Garbi · Domenico Vitobello Received: 6 May 2008 / Accepted: 28 August 2008  Springer-Verlag 2008 Abstract Objective The aim of this study was to describe the feasi- bility and morbidity rates associated with total laparoscopic radical hysterectomy (TLRH) with or without pelvic lym- phadenectomy for stage I endometrial cancer in obese women. Patients and methods Obese patients with stage I endo- metrial cancer who underwent total laparoscopic radical surgery at the Department of Obstetrics and Gynecology of San Gerardo Hospital were compared to nonobese patients. The same group of obese patients was compared with patients who underwent radical laparotomic surgery. Obes- ity was deWned as a body mass index more than 30 kg/m 2 . Results Between September 2003 and September 2007, 75 women underwent TLRH. Median age was 54 years and median body mass index was 28 kg/m 2 . Thirty-seven women were obese. There were no diVerences between nonobese and obese women in operative, time length of parametria and pelvic nodes removed and operative or late complications. Blood loss was signiWcantly higher in obese patients. Comparing retrospectively laparoscopy and laparotomy in obese women treated in our center, laparotomy was asso- ciated with decreased operative time, but also with increased blood loss, transfusion rate, duration of hospital- ization and frequency of post surgical complications. Conclusions Total laparoscopic radical hysterectomy (with pelvic lymphadenectomy) is a safe option in patients with endometrial cancer. Obesity is not a contraindication to perform a TRLH with no diVerences in surgical parame- ters between obese and nonobese population. TLRH show a signiWcant decrease of complications compared to laparo- tomic radical surgery in obese women. Keywords Laparoscopy · Endometrial cancer · Obesity · TLRH Introduction Endometrial cancer is the most common gynaecologic can- cer, with an incidence of almost 40,000 new cases per year in US [1]. Surgery is the cornerstone of the treatment and includes total abdominal hysterectomy (TAH), bilateral salpingo- oophorectomy (BSO) and endo or retroperitoneal staging according to histological patterns [2]. The advances of minimally invasive surgery have made this approach useful also in gynecologic oncology, includ- ing the treatment of both cervical and endometrial carci- noma. Many authors have reported their experiences about treatment of endometrial cancer by total laparoscopic hysterectomy (TLH) and laparoscopic-assisted vaginal hysterectomy (LAVH), showing a decrease of surgical complication, blood loss, transfusions and length of hospital stay, with an improvement of quality of life (QOL) parameters after TLH compared to abdominal hysterectomy [3–7]. At the moment, there are no reports about the feasibility of total laparoscopic radical hysterectomy and pelvic lym- phadenectomy in obese women. The purpose of this study was to evaluate the role of total laparoscopic radical hysterectomy (TLRH), with or A. Pellegrino · M. Signorelli · R. Fruscio (&) · A. Villa · A. Buda · P. Beretta · A. Garbi · D. Vitobello Clinica Ostetrica e Ginecologica, Division of Gynecologic Oncology, Ospedale San Gerardo, University of Milan-Bicocca, Monza, Milan, Italy e-mail: robilandia@gmail.com