术中开放后腹膜对妇科恶性肿瘤患者术后淋巴囊肿形成的影响

Impact of opening retroperitoneum on formation of post-operative lymphocyst in patients with gynecological cancer

摘要:

目的  探讨妇科恶性肿瘤淋巴结清扫术的患者术中开放后腹膜对术后淋巴囊肿形成的影响。方法  回顾性分析2009年10月-2015年4月该院收治的267例妇科恶性肿瘤行广泛子宫切除或全子宫切除及盆腔淋巴结清扫术患者的临床资料。其中开放后腹膜组148例，关闭后腹膜组119例。比较两组手术时间、术后72h盆腹腔引流量、手术后发热时间、术后肛门排气时间及淋巴囊肿形成的差异。结果  开放后腹膜组淋巴囊肿发生率为5.4%，关闭后腹膜组患者淋巴囊肿发生率为17.6%，开放后腹膜组术后淋巴囊肿的形成率低于关闭后腹膜组（P <0.05）。在术后形成淋巴囊肿的患者中，开放后腹膜组3例、关闭后腹膜组8例患者出现轻微临床症状。开放后腹膜组术后72 h盆腹腔引流量多于关闭后腹膜组（P <0.05）。两组患者术后肛门排气时间及术后发热时间比较，差异无统计学意义（P >0.05）。结论  妇科恶性肿瘤盆腔淋巴结清扫术中开放后腹膜可以有效降低术后盆腔淋巴囊肿的发生率。

Abstract:

Objective To discuss impact of opening retroperitoneum in pelvic lymph node dissection on formation of post-operative lymphocyst in patients with gynecological cancer. Methods Totally 267 patients of gynecologic malignancies who underwent radical hysterectomy or panhysterectomy and pelvic lymph node dissection from October 2009 to April 2015 were divided into two groups: open-retroperitoneum group (group A, 148 cases) and close-retroperitoneum group (group B, 119 cases). The differences in operation time, 72-hour drainage volume, postoperative fever time, postoperative anal exhaust time and number of pelvic lymphocysts were compared between the two groups. Results The rate of lymphatic cyst formation was 5.4% in the group A which was significantly lower than 17.6% in the group B (P < 0.05). There were 3 cases in the group A and 8 cases in the group B with mild clinical symptoms and signs. The 72-hour pelvic drainage volume after operation in the group A was higher than that in the group B (P < 0.05). The postoperative anal exhaust time and postoperative fever time were significantly different between the two groups (P > 0.05). Conclusions Opening retroperitoneum during pelvic lymphadenectomy for gynecologic malignancies can effectively prevent the formation of postoperative pelvic lymphcysts.