Introduction/Background RSS surgery is an option for EC treatment and its feasibility for lymph node assessment and SLN mapping has been describe.We analyzed RSS and RM approaches to treat low risk EC.

Methodology Prospective multicenter cohort study, setting in Santa Chiara Hospital of Trento and University Hospital of Pavia and Novara. Between January 2017 and January 2019, 76 consecutive patients with diagnosis of endometrial atypical hyperplasia or low risk (Grading 1–2, myometrial invasion <50%) EC undergoing robotic TH and SLN mapping were included. Data on patient‘s characteristics, surgical outcomes, QoL and cosmesis were prospectively collected and analyzed based on the surgical approach (RSS vs RM). Clinical follow up was performed at 4 weeks, 6 and 12 months after surgery.

Results 51 patients underwent RM and 25 RSS surgery. Main differences between the two groups were: mean BMI in RM group: 29 Kg/m², RSS: 24.8 kg/m² (p-value <0.001), drop haemoglobin in RM: 0.98 mg/mL, RSS: 1.47 mg/mL (p-value 0.013). No differences were found in term of SLN detection: 96.1% in RM (66.7% bilateral, 29.4% monolateral) and 96% in RSS (76% bilateral, 20% monolateral). In one RSS case the removal of right common iliac SLN was not feasible. We found a better physical functioning in RSS (97.1 vs 91.6, p-value 0.006) at 6 and 12 months after surgery and less pain in RM (98.6 vs 94.4, P-value 0.029) at 6 months. No differences in complications and cosmesis were detected.

Conclusion In the treatment of low risk EC with SLN mapping, we did not find any substantial advantages between the two approaches but we evidenced technical limitation in the removal SLN in RSS group.

Disclosure Nothing to disclose.