早期子宫颈癌患者术后盆腔淋巴囊肿的发生情况及原因分析

Analysis of the Occurrence and Causes of Postoperative Pelvic Lymphatic Cysts in Patients with Early-Stage Cervical Cancer

目的:探究早期子宫颈癌患者接受手术治疗后盆腔淋巴囊肿的发生及其与临床病理因素的相关性。方法:回顾性分析2013年1月至2015年12月,以及2019年1月至2019年12月于云南省肿瘤医院妇科接受初始根治性手术的663例早期子宫颈癌患者的临床资料,并根据术后是否发生盆腔淋巴囊肿分为淋巴囊肿组和无淋巴囊肿组。采用单因素和多因素Logistic回归分析术后盆腔淋巴囊肿形成的危险因素。结果:663例接受手术治疗的早期子宫颈癌患者术后盆腔淋巴囊肿的发生率为62.59%(415/663)。单因素分析显示盆腔淋巴囊肿的发生与使用的引流管类型和术后是否接受辅助化疗有关(P<0.05)。多因素分析结果显示使用负压引流管是术后盆腔淋巴囊肿发生的保护因素(P<0.05)。单因素分析显示盆腔淋巴囊肿的发生时间与FIGO分期、肿瘤分化程度、子宫颈肌壁浸润深度、切除淋巴结总数、切除髂总淋巴结总数、是否存在淋巴结转移、使用引流管类型和术后是否接受放化疗有关(P<0.05)。多因素分析显示使用负压引流管、术后未接受辅助放化疗是淋巴囊肿早期形成的保护因素(P<0.05)。结论:相较传统T型引流管,使用负压引流管可能可以降低早期子宫颈癌患者术后盆腔淋巴囊肿的发生率;术后接受辅助放化疗的患者发生盆腔淋巴囊肿的时间可能更早。

Objective:To explore the occurrence of pelvic lymphatic cysts in patients with early-stage cervical cancer after surgery and its correlation with clinicopathological factors.Methods:The clinical data of 663 patients with early-stage cervical cancer who underwent initial radical surgery at the Department of Gynecology,Yunnan Cancer Hospital between January 2013 and December 2015,and between January 2019 and December 2019,were retrospectively analyzed and divided into lymphatic cyst group and non lymphatic cyst group according to whether pelvic lymphatic cysts occurred after surgery.The risk factors for the formation of postoperative pelvic lymphatic cysts were analyzed using univariate and multifactorial logistic regression.Results:The incidence of pelvic lymphatic cysts in 663 patients with early cervical cancer undergoing initial radical surgery was 62.59%(415/663).Univariate analysis showed that the occurrence of the pelvic lymphatic cyst was related to the type of drainage tube used and whether to receive adjuvant chemotherapy after surgery(P<0.05).Multivariate analysis showed that the use of negative pressure drainage tube was an independent protective factor for the formation of pelvic lymphatic cysts after operation(P<0.05).Univariate analysis showed that the occurrence time of lymphatic cysts was related to FIGO staging,degree of differentiation,depth of cervical muscle wall infiltration,total number of excised lymph nodes,total number of excised iliac lymph nodes,presence of lymph node metastasis,the type of drainage tubeused,whether receiving postoperative radiotherapy and chemotherapy(P<0.05).Multivariate analysis showed that the use of negative pressure drainage tube and the absence of postoperative adjuvant radiotherapy and chemotherapy were independent protective factors affecting early formation of lymphatic cyst(P<0.05).Conclusions:Compared with traditional T-shaped drainage tubes,the use of negative pressure drainage tubes may reduce the incidence of pelvic lymphatic cysts after surgery in patients with early-stage cervical cancer.Patients who received adjuvant radiotherapy and chemotherapy after radical surgery may develop pelvic lymphatic cysts earlier.