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is an obesity epidemic in the Western World. Currently one in four adults is obese and three in ten children in the
UK is overweight or obese . The UK Foresight Study  predicts that if
nothing is done, this figure will rise to five in ten (50%) in women by 2050.
The endocrine changes induced by obesity
lead to an increased incidence of endometrial cancer. The majority of women with endometrial cancer present with early disease which means that surgery will form all or part of their
treatment. This presents serious challenges as these women often have
associated comorbid conditions. In this article we explore the relationship
between obesity and endometrial cancer and
highlight the surgical challenges.
Purpose: The aim of this
pilot study was to evaluate subjective and objective findings on short-term post-operative discomfort in patients receiving flapless implant surgery compared to
traditional open flap surgery. Materials and Methods: A two-centre, prospective
survey study was conducted, using a customized questionnaire. Between
December 2010 and January 2012, 20 patients were consecutively included.
Eleven received conventional open-flap surgery and nine received flapless
surgery. Inflammatory signs, analgesic consumption and sleeping difficulties
were evaluated up to seven days postoperatively. A clinical examination was
made one week postoperatively. Results:
Significantly less experienced swelling was noted 24 hours after
flapless surgery compared to open flap surgery for patients receiving four implants
or more, and at three days postoperatively for patients receiving single
implants. No difference concerning sleeping difficulties, pain or analgesic consumption
was found. Clinical examination one week
postoperatively showed no differences in wound gaps, redness of the
mucosa, or presence of pus between the groups. Conclusions: In conclusion,
flapless surgery seems to have a limited effect on postoperative comfort and
short-term post-operative signs of soft tissue healing compared to open flap
surgery. There is a need for larger randomized trials for evaluating
differences in postoperative discomfort between the two surgical techniques.