Clinical Analysis About The Cases Of Cervical Cancer Operations And The Research Of Complications

Objective:Through 215 cases of cervical cancer surgery,Comparatively analyze the outcomes of LRH and ARH. Classify of preoperative complications by ClavienDindo classification,and analyze the risk factors about complications,so as to provide a reference for accumulate more surgical experiences,preoperative evaluation,reduce the incidence of complications.Methods:A retrospective analysis of clinical data of cervical caner surgery was collected from March 2010 to March 2014, which conclude the management of preoperative,intraoperative and postoperative data,and postoperative follow-up data,were collected. Divide into two groups:LRH group( n=123) and ARH group(n=92),analyze and compare the difference of operating time,blooding volume,postoperative hospital stay,the number of lymph node resection, complications between two groups and postoperative follow-up data,Assess the safety and feasibility of two groups. according to Clavien-Dindo classification, classify the intraoperative and postope-rative complications,Compare and Valuate these two kinds of complications.Logistic regression analyze whether over danger grade II complications have any relationship with independent risk factors,for example,over50 year old,BMI show overweight, opearting time,et al.Results:1.From 215 cases of the study,LRH and ARH were successfully implemented.LRH group have no conversion to open surgery.significant difference was found between the two groups when compared drainage tube removal time,postoperative hospital stay,catheter removal time,anal exhausting time,Blood transfusion,P<0.05.there are no significant difference between operating time and the number of removed lymph nodes,p>0.05.2.The type and morbidity of intraoperative and postoperative complications is different in the two groups, there are no significant difference between twogroups,P>0.05.In LRH group,Subcutaneous emphysema is common in intraoperative complications. Postoperative morbidity,Urinary retention and postoperative Anemia are common in postoperative complications.In ARH group,Iliac vein ingury is common in intraoperative complications. It has the same major postoperative complications as LRH group.3.Clavien-Dindo classification classify 6 kinds of complications to grade I,and also 6 kinds to grade II,1 kind to grade IIIa,5 kinds to grade IIIb,according to Wilcoxon rank sum test,there are no significant difference in the criticality of intraoperative and postoperative of two groups.P>0.05.4. Logistic regression analysis show that over criticality grade II of LRH intraoperative complication related to operating time, operating time is a independent risk factor,P<0.05.BMI,Diabetes,Hypertension et al are not the risk factors of the LHR postoperative complication,P>0.05,no significant difference were found.Over criticality grade II of ARH intraoperative complication related to aged over 50 th,there is a significant difference,P<0.05.and aged over 50 th is a independent risk factor of ARH intraoperative complication.BMI>25 is a independent risk factor of ARH postoperative cmolication,P<0.05.5.There was a remarkable difference(P<0.05) in the late mortality rate between LRH and ARH group,There was no statistical significance of recurrence rate between two groups.Conclusions:1.LRH can get the same surgical outcomes as ARH,LHR has the same Safety and Accessibility as ARH,and LRH has more advantages in blooding volume and late mortality rate et al than ARH.2.Introperative and Postoperative Complication morbidity of LRH and ARH(3.2% VS2.7%)(69%VS62%)respectively.two groups criticality has no difference.3.Clavien-Dindo classification directly valuate the complications.and there are no difference between two groups.4.Over aged 50 s,BMI≥25,Operating time are the independent risk factors of intraoperative and postoperative complications respectively.