{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:45:40Z","timestamp":1787071540969,"version":"build-2736575974"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A retrospective case series study was conducted on four women (body mass index [BMI] \u226535 kg\/m\u00b2) 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\u2019s weight loss before surgery, and surgery-related parameters included the time of surgery, the amount of blood loss, and the presence of surgical complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Patients experienced a median weight reduction of 13.7 kg (range, 9.1\u201317.4 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\u00b0\u201319\u00b0, which facilitated adequate surgical visualization. No adverse effects or postoperative complications were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/gmit.gmit-d-25-00050","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T17:00:20Z","timestamp":1760115620000},"page":"337-342","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative Management with Mazindol for Obese Women Diagnosed with Endometrial Carcinoma Undergoing Robot-assisted Hysterectomy: A Pilot Case Series and Literature Review"],"prefix":"10.4103","volume":"14","author":[{"given":"Kuniaki","family":"Ota","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kawasaki Medical School, Kurashiki, Okayama, Japan"},{"name":"Fukushima Medical Center for Children and Women, Fukushima Medical University, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshifumi","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Fukushima Medical Center for Children and Women, Fukushima Medical University, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiaki","family":"Ota","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kawasaki Medical School, Kurashiki, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumiko","family":"Morimoto","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kawasaki Medical School, Kurashiki, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hana","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kawasaki Medical School, Kurashiki, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shogo","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kawasaki Medical School, Kurashiki, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wataru","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kawasaki Medical School, Kurashiki, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuru","family":"Shiota","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kawasaki Medical School, Kurashiki, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Shimoya","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kawasaki Medical School, Kurashiki, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,10,9]]},"reference":[{"key":"R1-20251107","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1111\/1471-0528.12106","article-title":"Obesity-driven endometrial cancer: Is weight loss the answer?","volume":"120","author":"Mackintosh","year":"2013","journal-title":"BJOG"},{"key":"R2-20251107","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1016\/j.jmig.2016.08.003","article-title":"Association between body mass index, uterine size, and operative morbidity in women undergoing minimally invasive hysterectomy","volume":"23","author":"Shah","year":"2016","journal-title":"J Minim Invasive Gynecol"},{"key":"R3-20251107","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/j.jmig.2019.04.001","article-title":"Differences in postoperative morbidity among obese patients undergoing abdominal versus laparoscopic hysterectomy for benign indications","volume":"27","author":"Tyan","year":"2020","journal-title":"J Minim Invasive Gynecol"},{"key":"R4-20251107","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1097\/AOG.0000000000000733","article-title":"Association between obesity and the trends of routes of hysterectomy performed for benign indications","volume":"125","author":"Mikhail","year":"2015","journal-title":"Obstet Gynecol"},{"key":"R5-20251107","doi-asserted-by":"crossref","first-page":"1848","DOI":"10.1007\/s11695-012-0737-6","article-title":"Preoperative nutritional interventions in morbid obesity: Impact on body weight, energy intake, and eating quality","volume":"22","author":"Melendez-Ara\u00fajo","year":"2012","journal-title":"Obes Surg"},{"key":"R6-20251107","doi-asserted-by":"crossref","first-page":"588016","DOI":"10.3389\/fendo.2021.588016","article-title":"Case report: Off label utilization of topiramate and metformin in patients with BMI \u226550 kg\/m (2) prior to bariatric surgery","volume":"12","author":"Sari","year":"2021","journal-title":"Front Endocrinol (Lausanne)"},{"key":"R7-20251107","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1159\/000531459","article-title":"Efficacy of intragastric balloon versus liraglutide as bridge to surgery in super-obese patients","volume":"16","author":"Martines","year":"2023","journal-title":"Obes Facts"},{"key":"R8-20251107","doi-asserted-by":"crossref","first-page":"199S","DOI":"10.1093\/ajcn\/55.1.199s","article-title":"Clinical and basic aspects of an anorexiant, mazindol, as an antiobesity agent in Japan","volume":"55","author":"Inoue","year":"1992","journal-title":"Am J Clin Nutr"},{"key":"R9-20251107","doi-asserted-by":"crossref","first-page":"1860","DOI":"10.3390\/jcm13071860","article-title":"Changes in body weight in severely obese patients treated with the anorexiant mazindol","volume":"13","author":"Tanaka","year":"2024","journal-title":"J Clin Med"},{"key":"R10-20251107","doi-asserted-by":"crossref","first-page":"e13419","DOI":"10.1111\/ases.13419","article-title":"Feasible techniques named \u201cpure\u201d robotic simple hysterectomy with 4 robotic arms \u201c4+0\u201d mode for hysterectomy in da Vinci Xi","volume":"18","author":"Ota","year":"2025","journal-title":"Asian J Endosc Surg"},{"key":"R11-20251107","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.jmig.2014.07.014","article-title":"The impact of obesity on the 30-day morbidity and mortality after surgery for endometrial cancer","volume":"22","author":"Mahdi","year":"2015","journal-title":"J Minim Invasive Gynecol"},{"key":"R12-20251107","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.ygyno.2017.01.025","article-title":"Impact of body mass index and operative approach on surgical morbidity and costs in women with endometrial carcinoma and hyperplasia","volume":"145","author":"Suidan","year":"2017","journal-title":"Gynecol Oncol"},{"key":"R13-20251107","doi-asserted-by":"crossref","first-page":"i2156","DOI":"10.1136\/bmj.i2156","article-title":"BMI and all cause mortality: Systematic review and non-linear dose-response meta-analysis of 230 cohort studies with 3.74 million deaths among 30.3 million participants","volume":"353","author":"Aune","year":"2016","journal-title":"BMJ"},{"key":"R14-20251107","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1093\/jnci\/djab197","article-title":"Prospective cohort study of pre- and postdiagnosis obesity and endometrial cancer survival","volume":"114","author":"Kokts-Porietis","year":"2022","journal-title":"J Natl Cancer Inst"},{"key":"R15-20251107","doi-asserted-by":"crossref","first-page":"e13337","DOI":"10.1111\/obr.13337","article-title":"Obesity and mortality among endometrial cancer survivors: A systematic review and meta-analysis","volume":"22","author":"Kokts-Porietis","year":"2021","journal-title":"Obes Rev"},{"key":"R16-20251107","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1002\/ags3.12049","article-title":"Obesity as a surgical risk factor","volume":"2","author":"Ri","year":"2018","journal-title":"Ann Gastroenterol Surg"},{"key":"R17-20251107","doi-asserted-by":"crossref","first-page":"znae284","DOI":"10.1093\/bjs\/znae284","article-title":"Role of obesity-management medications before and after metabolic bariatric surgery: A systematic review","volume":"111","author":"Cohen","year":"2024","journal-title":"Br J Surg"},{"key":"R18-20251107","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1016\/j.soard.2019.01.012","article-title":"Predictors and outcomes of leak after Roux-en-Y gastric bypass: An analysis of the MBSAQIP data registry","volume":"15","author":"Mocanu","year":"2019","journal-title":"Surg Obes Relat Dis"},{"key":"R19-20251107","first-page":"e12406","article-title":"Pre-specified weight loss before bariatric surgery and postoperative outcomes","volume":"12","author":"Chinaka","year":"2020","journal-title":"Cureus"},{"key":"R20-20251107","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1016\/S0140-6736(14)60460-8","article-title":"Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: A systematic analysis for the Global Burden of Disease Study 2013","volume":"384","author":"Ng","year":"2014","journal-title":"Lancet"},{"key":"R22-20251107","doi-asserted-by":"crossref","first-page":"e204803","DOI":"10.1001\/jamanetworkopen.2020.4803","article-title":"Association of preoperative body weight and weight loss with risk of death after bariatric surgery","volume":"3","author":"Sun","year":"2020","journal-title":"JAMA Netw Open"},{"key":"R23-20251107","first-page":"20","article-title":"What is ozempic and why is it getting so much attention?","volume":"1","author":"Blum","year":"2022","journal-title":"Peri\u00f3dicos Brasil Pesqui Cient"},{"key":"R24-20251107","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1007\/s11695-023-06484-8","article-title":"Efficacy of the glucagon-like peptide-1 receptor agonists liraglutide and semaglutide for the treatment of weight regain after bariatric surgery: A retrospective observational study","volume":"33","author":"Jensen","year":"2023","journal-title":"Obes Surg"},{"key":"R25-20251107","doi-asserted-by":"crossref","first-page":"2179","DOI":"10.2147\/JMDH.S419245","article-title":"Usage of glucagon-like peptide-1 for obesity in children;updated review of clinicaltrials.gov","volume":"16","author":"Alorfi","year":"2023","journal-title":"J Multidiscip Healthc"},{"key":"R26-20251107","doi-asserted-by":"crossref","first-page":"214","DOI":"10.2174\/157488412800958686","article-title":"GLP-1 agonists exenatide and liraglutide: A review about their safety and efficacy","volume":"7","author":"Derosa","year":"2012","journal-title":"Curr Clin Pharmacol"},{"key":"R27-20251107","doi-asserted-by":"crossref","first-page":"1782","DOI":"10.1093\/ckj\/sfac090","article-title":"Semaglutide for treatment of obesity in hemodialysis patients waiting for a kidney transplant: New hope?","volume":"15","author":"Touzot","year":"2022","journal-title":"Clin Kidney J"},{"key":"R28-20251107","doi-asserted-by":"crossref","first-page":"luad067","DOI":"10.1210\/jcemcr\/luad067","article-title":"Meeting the body mass index requirement for gender-affirming surgery using antiobesity medication","volume":"1","author":"Taormina","year":"2023","journal-title":"JCEM Case Rep"},{"key":"R29-20251107","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1007\/s00125-016-3874-y","article-title":"GLP-1 receptors exist in the parietal cortex, hypothalamus and medulla of human brains and the GLP-1 analogue liraglutide alters brain activity related to highly desirable food cues in individuals with diabetes: A crossover, randomised, placebo-controlled trial","volume":"59","author":"Farr","year":"2016","journal-title":"Diabetologia"},{"key":"R30-20251107","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1002\/ar.1090780203","article-title":"Hypothalamic lesions and adiposity in the rat","volume":"78","author":"Hetherington","year":"1940","journal-title":"Anat Rec"},{"key":"R31-20251107","doi-asserted-by":"crossref","first-page":"323","DOI":"10.3181\/00379727-77-18766","article-title":"Localization of a \u201cfeeding center\u201d in the hypothalamus of the rat","volume":"77","author":"Anand","year":"1951","journal-title":"Proc Soc Exp Biol Med"},{"issue":"Suppl 4","key":"R32-20251107","first-page":"549S","article-title":"Clinical studies with mazindol","volume":"3","author":"Inoue","year":"1995","journal-title":"Obes Res"},{"key":"R33-20251107","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1185\/03007997509113660","article-title":"A multi-Centre trial of mazindol (\u2018Teronac\u2019) in general practice in Ireland","volume":"3","author":"Evans","year":"1975","journal-title":"Curr Med Res Opin"},{"key":"R34-20251107","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1253\/jcj.64.218","article-title":"Delayed onset of pulmonary hypertension associated with an appetite suppressant, mazindol: A case report","volume":"64","author":"Hagiwara","year":"2000","journal-title":"Jpn Circ J"},{"key":"R35-20251107","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1016\/j.ajog.2019.05.004","article-title":"Laparoscopic and robotic hysterectomy in endometrial cancer patients with obesity: A systematic review and meta-analysis of conversions and complications","volume":"221","author":"Cusimano","year":"2019","journal-title":"Am J Obstet Gynecol"},{"key":"R36-20251107","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.jmig.2012.03.014","article-title":"Blinded measure of Trendelenburg angle in pelvic robotic surgery","volume":"19","author":"Gould","year":"2012","journal-title":"J Minim Invasive Gynecol"},{"key":"R37-20251107","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.jmig.2012.03.019","article-title":"Trendelenburg position in gynecologic robotic-assisted surgery","volume":"19","author":"Ghomi","year":"2012","journal-title":"J Minim Invasive Gynecol"}],"container-title":["Gynecology and Minimally Invasive Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/gmit.GMIT-D-25-00050","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:47:50Z","timestamp":1787068070000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/gmit.GMIT-D-25-00050"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":36,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/gmit.gmit-d-25-00050","relation":{},"ISSN":["2213-3070","2213-3089"],"issn-type":[{"value":"2213-3070","type":"print"},{"value":"2213-3089","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2025-04-08","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-06","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}