Abdominoplasty in patients with endometrial cancer and morbid obesity

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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