Obesity and perioperative outcomes of robotic-assisted surgery for endometrial cancer: a systematic review and meta-analysis.

This systematic review and meta-analysis evaluated perioperative outcomes after robotic-assisted surgery for endometrial cancer in obese versus non-obese patients, as classified in the source studies. PubMed, Embase, Web of Science, and the Cochrane Library were searched for comparative studies of robotic-assisted surgery for endometrial cancer. Obesity was defined as BMI ≥ 30 kg/m² according to each study. The included data were not uniformly restricted to BMI < 40 kg/m²; consequently, the analysis does not represent class I-II obesity alone. Eight retrospective studies involving 1,879 patients were included. No statistically significant differences were detected in operative time (MD, - 9.02 min; 95% CI, - 21.25 to 3.20; p = 0.15), estimated blood loss (MD, 35.69 mL; 95% CI, - 40.54 to 111.93; p = 0.36), or length of stay (MD, - 0.25 days; 95% CI, - 0.61 to 0.10; p = 0.16). Pooled complication estimates were also nonsignificant. These findings do not establish equivalent safety. In the included retrospective studies, obesity as classified by the original reports was not associated with statistically significant differences in the assessed perioperative outcomes after robotic-assisted surgery. The estimates are imprecise and potentially confounded; they do not establish equivalence or demonstrate superiority over other surgical approaches.