grekovВестник хирургии имени И.И. ГрековаGrekov's Bulletin of Surgery0042-46252686-7370Federal State Budgetary Educational Institution of Higher Education «Academician I.P. Pavlov First St. Petersburg State Medical University» of the Ministry of Healthcare of the Russion Federation, FSBEI HE I.P.Pavlov SPbSMU MOH Russia10.24884/0042-4625-2026-185-1-49-58grekov-2759Research ArticleВОПРОСЫ ОБЩЕЙ И ЧАСТНОЙ ХИРУРГИИPROBLEMS OF GENERAL AND SPECIAL SURGERYАбдоминопластика у больных раком эндометрия и морбидным ожирениемAbdominoplasty in patients with endometrial cancer and morbid obesityhttps://orcid.org/0000-0002-2773-1917ВиллертА. Б.VillertA. B.

Виллерт Алиса Борисовна, доктор медицинских наук, старший научный сотрудник отделения онкогинекологии

634050, г. Томск, пер. Кооперативный, д. 5

Villert Alisa B., Dr. of Sci. (Med.), Senior Research Fellow of the Department of Oncogynecology

5, Kooperativny per., Tomsk, 634050

Researcher ID WoS: J-3140-2017

Autor ID Scopus: 56626547700

avillert@yandex.ruhttps://orcid.org/0000-0002-6854-8940КоломиецЛ. А.KolomietsL. A.

Коломиец Лариса Александровна, доктор медицинских наук, профессор, заслуженный деятель науки РФ, руководитель отделения онкогинекологии

634050, г. Томск, пер. Кооперативный, д. 5

Researcher ID WoS: C-8573-2012

Autor ID Scopus: 7004921120

Kolomiets Larisa A., Dr. of Sci. (Med.), Professor, Honored Scientist of the Russian Federation, Head of the Department of Oncogynecology

5, Kooperativny per., Tomsk, 634050

2, Moscow tract, Tomsk, 634050

Researcher ID WoS: C-8573-2012

Autor ID Scopus: 7004921120

https://orcid.org/0000-0003-3439-8830ЧуруксаеваО. Н.ChuruksaevO. N.

Чуруксаева Ольга Николаевна, доктор медицинских наук, старший научный сотрудник отделения онкогинекологии

634050, г. Томск, пер. Кооперативный, д. 5

Author ID: 557906

Researcher ID (WOS): C-8601-2012

Author ID (Scopus): 6504391579

Churuksaeva Olga N., Dr. of Sci. (Med.), Senior Research Fellow of the Department of Oncogynecology

5, Kooperativny per., Tomsk, 634050

https://orcid.org/0000-0001-6628-2918ОчировМ. О.OchirovM. O.

Очиров Максим Олегович, кандидат медицинских наук, научный сотрудник отделения гинекологии

634050, г. Томск, пер. Кооперативный, д. 5

eLibrary SPIN-код: 5901-2291

Author ID Scopus: 57204634789

Researcher ID (WoS): K-1722-2017

Ochirov Maksim O., Cand. of Sci. (Med.), Research Fellow of the Department of Gynecology

5, Kooperativny per., Tomsk, 634050

Author ID Scopus: 57204634789

Researcher ID (WoS): K-1722-2

maksimmf@mail.ruhttps://orcid.org/0000-0001-8212-731XМальцеваА. А.MalstevaA. A.

Мальцева Анастасия Алексеевна, аспирант

634050, г. Томск, пер. Кооперативный, д. 5

Researcher ID WoS: KPB-1860-2024

Author ID Scopus: 57215558396

Malsteva Anastasia A., Postgraduate Student

5, Kooperativny per., Tomsk, 634050

Researcher ID WoS: KPB-1860-2024

Author ID Scopus: 57215558396

maltseva.anast@gmail.comhttps://orcid.org/0009-0005-3456-7624МамоноваТ. Ю.MamonovaT. Yu.

Мамонова Татьяна Юрьевна, кандидат медицинских наук, научный сотрудник

634050, г. Томск, пер. Кооперативный, д. 5

Mamonova Tatiana Yu., Cand. of Sci. (Med.), Research Fellow

5, Kooperativny per., Tomsk, 634050

ВиллертС. А.VillertS. A.

Виллерт София Андреевна, студент Лечебного факультета

634050, г. Томск, Московский тракт, д. 2

Villert Sofiya A., Student of the Faculty of Medicine

2, Moscow tract, Tomsk, 634050

Svillert11@gmail.comВершковаА. Е.VershkovaA. E.

Вершкова Алина Евгеневна, студент Лечебного факультета

634050, г. Томск, Московский тракт, д. 2

Vershkova Alina E., Student of the Faculty of Medicine

2, Moscow tract, Tomsk, 634050

polyakova_alina@list.ruНаучно-исследовательский институт онкологии – филиал Федерального государственного бюджетного научного учреждения «Томский национальный исследовательский медицинский центр Российской академии наук»РоссияCancer Research Institute is a subdivision of the Federal State Budgetary Scientific Institution “Tomsk National Research Medical Center of the Russian Academy of Sciences”Russian FederationНаучно-исследовательский институт онкологии – филиал Федерального государственного бюджетного научного учреждения «Томский национальный исследовательский медицинский центр Российской академии наук»; Сибирский государственный медицинский университетРоссияCancer Research Institute is a subdivision of the Federal State Budgetary Scientific Institution “Tomsk National Research Medical Center of the Russian Academy of Sciences”; Siberian State Medical UniversityRussian FederationНаучно-исследовательский институт онкологии – филиал Федерального государственного бюджетного научного учреждения «Томский национальный исследовательский медицинский центр Российской академии наук»РоссияCancer Research Institute is a subdivision of the Federal State Budgetary Scientific Institution “Tomsk National Research Medical Center of the Russian Academy of Sciences”Russian FederationСибирский государственный медицинский университетРоссияSiberian State Medical UniversityRussian Federation20262002202618514958Copyright © Виллерт А.Б., Коломиец Л.А., Чуруксаева О.Н., Очиров М.О., Мальцева А.А., Мамонова Т.Ю., Виллерт С.А., Вершкова А.Е., 20262026Виллерт А.Б., Коломиец Л.А., Чуруксаева О.Н., Очиров М.О., Мальцева А.А., Мамонова Т.Ю., Виллерт С.А., Вершкова А.Е.Villert A.B., Kolomiets L.A., Churuksaev O.N., Ochirov M.O., Malsteva A.A., Mamonova T.Y., Villert S.A., Vershkova A.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vestnik-grekova.ru/jour/article/view/2759

Рак эндометрия (РЭ) является наиболее частым гинекологическим онкологическим заболеванием, а ожирение признано одним из ключевых факторов его развития. Подтверждено значительное увеличение риска РЭ у женщин с ИМТ≥40 кг/м². Представлены основные моменты, касающиеся рисков РЭ при ожирении, способов модификации рисков и подходы к лечению рака у больных с ожирением. Несмотря на то, что использование минимально инвазивных методов, картирование сторожевого лимфоузла, программы ERAS и Fast Track позволяют минимизировать осложнения и улучшить исходы, выполнение хирургического вмешательства у больных РЭ с морбидным ожирением сопряжено с техническими трудностями, включая ограниченный доступ к органам малого таза, высокий риск интраоперационных и послеоперационных осложнений, а также удлинение времени наркоза. Абдоминопластика и панникулэктомия могут быть полезны для улучшения хирургического доступа и снижения рисков у этой категории больных. Приведены клинические наблюдения пациенток, перенесших абдоминопластику в сочетании с экстирпацией матки и лимфаденэктомией. Применение абдоминопластики в условиях выраженного панникулуса способствует улучшению качества оперативного этапа, не противоречит использованию видеоэндоскопического доступа.

Endometrial cancer (EC) is the most common gynecological cancer, and obesity is recognized as one of the key factors in its development. A significant increase in the EC risk has been confirmed in women with BMI>40 kg/m2. The main points concerning the EC risks in obesity, methods of risk modification and approaches to cancer treatment in obese patients are presented. Despite the fact that the use of minimally invasive methods, sentinel lymph node mapping, ERAS and Fast Track programs can minimize complications and improve outcomes, surgical intervention in patients with morbid obesity is associated with technical difficulties, including limited access to the pelvic organs, a high risk of intraoperative and postoperative complications, as well as prolongation of anesthesia time. Abdominoplasty and panniculectomy may be useful for improving surgical access and reducing risks in this category of patients. The clinical observations of female patients underwent abdominoplasty in combination with uterine extirpation and lymphadenectomy are presented. The use of abdominoplasty in pronounced panniculus helps to improve the quality of the surgical stage, does not contradict the use of video endoscopic access.

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The authors declare that there are no conflicts of interest present.