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#704 Three-dimensional anatomical model supporting laparoscopic pelvic lymphadenectomy in obese endometrial cancer patients: a case-control study
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  1. Emanuele Arturo Fera1,
  2. Federica Perelli1,
  3. Marco Giusti1,
  4. Stefano Restaino2,
  5. Giuseppe Vizzielli3,
  6. Anna Franca Cavaliere4,
  7. Giovanni Scambia5,
  8. Alberto Mattei1,
  9. Silvia Pisaneschi1,
  10. Aldo Altomare1,
  11. Silvia Scoccianti6,
  12. Barbara Grilli Leonulli6,
  13. Luisa Fioretto7,
  14. Francesca Martella7,
  15. Elena Molinara7,
  16. Carlotta Bacci7,
  17. Sheila Rangan7,
  18. Vittorio Pavoni8,
  19. Duccio Conti8 and
  20. Francesco Scaramuzzino9
  1. 1Santa Maria Annunziata Hospital, Florence, Italy
  2. 2Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
  3. 3University Hospital of Udine, Udine, Italy
  4. 4Fatebenefratelli Isola Tiberina Gemelli Hospital, Roma, Italy
  5. 5Policlinico A. Gemelli, Università cattolica del Sacro Cuore, Roma, Italy
  6. 6Struttura Organizzativa Complessa (SOC) Radioterapia Oncologica, Ospedale Santa Maria Annunziata, Florence, Italy
  7. 7Unit of Medical Oncology, Department of Oncology, S. Maria Annunziata Hospital, Florence, Italy
  8. 8Unità di Anestesia e Rianimazione, Santa Maria Annunziata Hospital, Florence, Italy
  9. 9Department of Human Pathology and Oncology, USL Toscana Centro, Florence, Italy

Abstract

Introduction/Background In early stages endometrial cancer (EC) patients, the standard surgical approach is hysterectomy and bilateral salpingoophorectomy, with pelvic lymphadenectomy or with sentinel lymph node staging, based on clinical and molecular risk factors.

The role of 3D imaging reconstruction is currently under debate.

The aim of this research is to assess the clinical value of a 3D imaging reconstruction model of pelvic lymphnodes to be used simultaneously in the operating room to identify lymphatic tissue in obese patients.

Methodology A study was performed on obese patients with EC treated between March and October 2022 in Santa Maria Annunziata Hospital (Florence) using REAL 3D-MIC device (group 1). Prior to surgery, we performed a 3D imaging reconstruction of pelvic lymphnodes used to guide the intraoperatively lymphadenectomy. This group was compared with a historical series of EC patients treated without the 3D model (group 2).

Results The two groups (group1=13 patients and group2=11 patients) showed homogeneous clinical characteristics. The correspondence between virtual 3D model and real anatomy was analyzed comparing lymphnodes location in virtual 3D model and operative data. We recorded a consistency of 85% (85% for group 1 vs 45% for group 2, p=0,06). In REAL 3D MIC group we found one nodal EC metastasis and one case of B cells Lymphoma synchronous to EC.

Conclusion REAL-3D MIC could improve the identification of lymphnodes simultaneously with surgery, especially in obese women. Further studies are needed to demonstrate the effectiveness of REAL- 3D MIC in lymphnodal mapping.

Disclosures The Authors have no conflicts of interests to declare.

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