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妇科癌症腹腔镜腹膜后淋巴结清扫术后女性发生淋巴囊肿的预测因素:一项回顾性队列研究。

Predictors of Lymphoceles in Women Who Underwent Laparotomic Retroperitoneal Lymph Node Dissection for Early Gynecologic Cancer: A Retrospective Cohort Study.

机构信息

Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei 220, Taiwan.

Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and the Hospital, Taipei 100, Taiwan.

出版信息

Int J Environ Res Public Health. 2019 Mar 15;16(6):936. doi: 10.3390/ijerph16060936.

Abstract

Lymphoceles could represent a detrimental complication after retroperitoneal lymph node dissection. Our aim was to elucidate predictors of lymphoceles. Between 2011 and 2017, medical records of consecutive women who underwent laparotomic retroperitoneal lymph node dissection for FIGO stage I or II gynecologic cancer were reviewed. A total of 204 women, including those with lymphoceles (n = 31) and symptomatic lymphoceles (n = 7), were reviewed. According to multivariable analysis, parity (odds ratio = 0.59, = 0.003), adjuvant pelvic radiotherapy (odds ratio = 2.60, = 0.039), and peritoneal nonclosure without pelvic drainage (odds ratio = 2.31, = 0.048) were predictors of lymphoceles. In addition, parity (odds ratio = 0.73, = 0.03), hypertension (odds ratio = 2.62, = 0.02), and peritoneal partial closure with pelvic drainage (odds ratio = 0.27, = 0.02) were predictors of complications. Low parity, adjuvant pelvic radiotherapy, and peritoneal nonclosure without pelvic drainage were associated with increased lymphocele formation. In addition, a lower complication rate was found in the peritoneal partial closure with pelvic drainage group; thus, peritoneal partial closure with pelvic drainage might be suggested for women who undergo laparotomic retroperitoneal lymph node dissection.

摘要

淋巴囊肿是腹膜后淋巴结清扫术后的一种有害并发症。我们的目的是阐明淋巴囊肿的预测因素。2011 年至 2017 年,回顾了连续接受剖腹式腹膜后淋巴结清扫术治疗 FIGO Ⅰ期或Ⅱ期妇科癌症的女性患者的病历。共回顾了 204 名女性患者,包括有淋巴囊肿(n=31)和有症状的淋巴囊肿(n=7)。多变量分析显示,产次(比值比=0.59,=0.003)、辅助盆腔放疗(比值比=2.60,=0.039)和无盆腔引流的腹膜关闭(比值比=2.31,=0.048)是淋巴囊肿的预测因素。此外,产次(比值比=0.73,=0.03)、高血压(比值比=2.62,=0.02)和有盆腔引流的腹膜部分关闭(比值比=0.27,=0.02)是并发症的预测因素。低产次、辅助盆腔放疗和无盆腔引流的腹膜关闭与淋巴囊肿形成增加有关。此外,在有盆腔引流的腹膜部分关闭组中发现并发症发生率较低;因此,对于接受剖腹式腹膜后淋巴结清扫术的女性,建议采用有盆腔引流的腹膜部分关闭。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80e6/6466375/75b5575a7601/ijerph-16-00936-g001.jpg

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