Department of Gynecology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, 350014, Fujian, China.
BMC Cancer. 2021 Nov 18;21(1):1242. doi: 10.1186/s12885-021-08984-1.
The study aims to evaluate the clinical features and management of postoperative lymphatic leakage (PLL) in patients with cervical cancer who received pelvic lymphadenectomy.
This retrospective study screened consecutive patients with cervical cancer (stage Ia2-IIb).
Among 3427 cases screened, 63 patients (1.8%) were diagnosed with PLL, which manifested as persistent abdominal drainage (42/63, 66.7%), chylous ascites (12/63, 19.0%) or vaginal drainage (9/63, 14.3%). Median time from surgery to onset of PLL was 6 days (range, 4-21 days). All cases resolved in a median 10 days (range, 3-56 days) after conservative treatment; although one case experienced recurrence of vaginal drainage after 26 days, this also resolved after conservative therapy. Multivariate analysis showed that two cycles of neoadjuvant chemotherapy (odds ratio [OR], 3.283; 95% confidence interval [95%CI], 1.289-8.360; P = 0.013), a decrease in hemoglobin level of ≥20 and < 30 g/L (OR, 6.175; 95%CI, 1.033-10.919; P = 0.046) or ≥ 30 g/L (OR, 8.467; 95%CI, 1.248-17.426; P = 0.029), and postoperative albumin level ≥ 30 and < 35 g/L (OR, 2.552; 95%CI, 1.112-5.857; P = 0.027) or < 30 g/L (OR, 5.517; 95%CI, 2.047-18.148; P = 0.012) were associated with PLL.
Neoadjuvant chemotherapy, postoperative anemia and postoperative hypoproteinemia are risk factors for PLL.
本研究旨在评估接受盆腔淋巴结清扫术的宫颈癌患者术后淋巴漏（PLL）的临床特征和处理方法。
本回顾性研究连续筛查了宫颈癌（Ia2-IIb 期）患者。
在筛查的 3427 例患者中，有 63 例（1.8%）被诊断为 PLL，其表现为持续性腹腔引流（42/63，66.7%）、乳糜性腹水（12/63，19.0%）或阴道引流（9/63，14.3%）。从手术到 PLL 发病的中位时间为 6 天（范围 4-21 天）。所有病例经保守治疗后中位 10 天（范围 3-56 天）内均得到解决；尽管有 1 例在 26 天后出现阴道引流复发，但经保守治疗后也得到解决。多变量分析显示，2 个周期的新辅助化疗（比值比 [OR]，3.283；95%置信区间 [95%CI]，1.289-8.360；P=0.013）、血红蛋白水平下降≥20 且<30 g/L（OR，6.175；95%CI，1.033-10.919；P=0.046）或≥30 g/L（OR，8.467；95%CI，1.248-17.426；P=0.029）和术后白蛋白水平≥30 且<35 g/L（OR，2.552；95%CI，1.112-5.857；P=0.027）或<30 g/L（OR，5.517；95%CI，2.047-18.148；P=0.012）与 PLL 相关。
新辅助化疗、术后贫血和术后低蛋白血症是 PLL 的危险因素。
