Gynecology and minimally invasive therapy · 2025
Preoperative Management with Mazindol for Obese Women Diagnosed with Endometrial Carcinoma Undergoing Robot-assisted Hysterectomy: A Pilot Case Series and Literature Review.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Ota Kuniaki, Takahashi Toshifumi, Ota Yoshiaki, Morimoto Yumiko, Okamoto Hana, Kawamura Shogo, Saito Wataru, Shiota Mitsuru, Shimoya Koichiro
Аннотация
OBJECTIVES: Obesity poses major perioperative challenges in gynecologic malignancies, particularly endometrial cancer, and increases surgical complexity and risk. Although robot-assisted hysterectomy (RAH) and bilateral salpingo-oophorectomy are preferred for early-stage cases, the obese patients make it limit their feasibility. Preoperative weight loss may improve outcomes; however, the pharmacological options remain understudied. This study explored the feasibility of a preoperative mazindol-based weight-loss program in severely obese patients.
MATERIALS AND METHODS: A retrospective case series study was conducted on four women (body mass index [BMI] ≥35 kg/m²) who were suspected of having stage 1A endometrial cancer based on preoperative magnetic resonance imaging between January 2021 and July 2024. The patients received nutritional counseling and mazindol (1.0 mg/day) before undergoing surgery. The effect of mazindol was indexed by each patient's weight loss before surgery, and surgery-related parameters included the time of surgery, the amount of blood loss, and the presence of surgical complications.
RESULTS: Patients experienced a median weight reduction of 13.7 kg (range, 9.1-17.4 kg), with a corresponding decrease in BMI. Operative time was 247.5 min, with a console time of 214 min and blood loss of 75 g. The Trendelenburg angle was 18°-19°, which facilitated adequate surgical visualization. No adverse effects or postoperative complications were observed.
CONCLUSION: Preoperative administration of mazindol resulted in significant weight loss, enabling safer RAH with reduced surgical complexity. This suggests that mazindol may be a viable option for weight reduction in obese patients absolutely requiring gynecologic surgery for malignant diseases.
MATERIALS AND METHODS: A retrospective case series study was conducted on four women (body mass index [BMI] ≥35 kg/m²) who were suspected of having stage 1A endometrial cancer based on preoperative magnetic resonance imaging between January 2021 and July 2024. The patients received nutritional counseling and mazindol (1.0 mg/day) before undergoing surgery. The effect of mazindol was indexed by each patient's weight loss before surgery, and surgery-related parameters included the time of surgery, the amount of blood loss, and the presence of surgical complications.
RESULTS: Patients experienced a median weight reduction of 13.7 kg (range, 9.1-17.4 kg), with a corresponding decrease in BMI. Operative time was 247.5 min, with a console time of 214 min and blood loss of 75 g. The Trendelenburg angle was 18°-19°, which facilitated adequate surgical visualization. No adverse effects or postoperative complications were observed.
CONCLUSION: Preoperative administration of mazindol resulted in significant weight loss, enabling safer RAH with reduced surgical complexity. This suggests that mazindol may be a viable option for weight reduction in obese patients absolutely requiring gynecologic surgery for malignant diseases.