298例盆腔淋巴结清除术后并发盆腔淋巴囊肿情况分析

Analysis of occurrence of pelvic lymphocyst after pelvic lymphadenectomy in 298 cases

目的总结分析盆腔淋巴结清除术后患者盆腔淋巴囊肿发生率及相关因素,探讨其防治措施。方法回顾性分析2002年1月至2008年6月期间于我院妇科行盆腔淋巴结清除术128例患者的临床资料,统计术后并发盆腔淋巴囊肿的情况,并分析其发生率与不同病种、盆腔后腹膜开闭情况、留置引流与否之间的关系。总结该并发症临床处理经验及预防措施。结果卵巢癌术后发生盆腔淋巴囊肿的几率显著小于宫颈癌及子宫内膜癌;术中开放盆腔后腹膜的患者淋巴囊肿发生率显著小于关闭盆腔后腹膜患者;是否留置盆腔腹膜后引流对淋巴囊肿发生率的影响未见统计学差异。结论保留盆腔后腹膜开放,对减少患者术后淋巴囊肿有意义;对于止血彻底、无副损伤的手术不必常规放置盆腔腹膜后引流。

Objective To analyse the occurrence of pelvic lymphocyst in patients undergoing pelvic lymphadenectomy and the relative factors, and to investigate measures for treatment and prevention of this post-operative complication. Methods 298 patients with the complication of lymphocyst after pelvic lymphadenectomy were analysed retrospectively. The influence of disease types, eloseing or opening of retropelvie peritonium, placement of drainage tube on the occurrence of lymphocyst was investigated in order to summarize prevention and treatment measures. Results The occurrence of lymphocyst in patients after ovarian cancer operation was significantly lower than that in patients with cervical cancer or endometrium cancer. Leaving the retropelvic peritonium open could reduce the occurrence of lymphocyst. No significant difference was found between patients with or without pelvic drainage tube. Conclusions Leaving the retropelvic peritonium open is meaningful to the prevention of lymphoeyst. If perfect hemostasis is achieved and no side damage, pelvic drainage tube should not be palced routinely.