Analysis Of The Influence Of Peritoneal Loboplatin Lavage On The Prognosis After Cervical Radical Resection And Related Risk Factors

Objective: Evaluate the safety of intraperitoneal lavage and retention of lobaplatin after cervical cancer radical surgery and its effect on progressionfree survival,and explore related clinical factors,pathological types,surgical methods,myometrial invasion depth,vascular tumor thrombus and other related risk factors Effect on tumor recurrence.Methord: A total of 121 patients with stage IA2-ⅡA1 cervical cancer confirmed by gynecological surgery and pathology from the Fourth Hospital of Hebei Medical University from February 2016 to August 2019 were selected and followed up to January 31,2020.They were randomly divided into the intervention group and the control group by the lottery method.Patients who underwent additional chemoradiotherapy and patients who received preoperative chemotherapy were excluded according to the guidelines "Sedlis standard" and "four-factor model".All patients were treated with laparoscopic radical C2 cervical cancer surgery.The intervention group was injected once with intraperitoneal injection.At the end of the operation,the pelvic cavity was rinsed with sterile injection water and sucked up.To avoid residual cancer cells within 24 hours after the operation,The G0 phase,which is resistant to chemotherapeutics,is changing to a proliferative phase.On the second day of the 3 days after surgery,where residual cancer cells are most sensitive to intraluminal chemotherapy,30 mg of lobaplatin is dissolved in 500 ml of saline.The abdominal cavity was lavaged,and the abdominal drainage tube was opened after 6 hours of retention.In the control group,the pelvic cavity was rinsed with sterilized injection water after suction,and one abdominal drainage tube was left open after the operation.The follow-up was 6,12,24,and 36 months.The difference in recurrence between the two groups was compared,and the clinical stage and pathology were compared.Related risk factors such as type,surgical method,myometrial invasion depth,and vascular tumor emboli were analyzed to evaluate its effect on tumor recurrence.Results:1.The general information of the two groups of patients: there was no statistically significant difference in age,pathological type,clinical stage,etc.There was no statistically significant difference in nausea,vomiting,thrombocytopenia,abnormal liver and kidney function,etc.(P> 0.05),the intraperitoneal lavage of lobaplatin is safe without significant side effects.2.During the follow-up period,8 patients relapsed in the control group and 1 in the intervention group.The control group relapsed as early as 6 months after operation,and the intervention group relapsed as early as 25 months after operation.In the intervention group,the recurrence rates at 12,24,and 36 months after surgery were 0%,3.23%,and 3.23%;the recurrence rates at control group at 6,12,24,and 36 months were 1.59%,3.18%,11.68%,and 14 %.Compared with the control group,the recurrence rate of 2 years was significantly different(P < 0.05).Compared with the relapse rate of 3 years,the difference was not statistically significant(P > 0.05).3.There was no significant difference in the recurrence rates of open surgery and laparoscopy between the two groups(P> 0.05),but the recurrence rate of laparoscopy in the intervention group was lower than that in the control group(P <0.05);There was no significant difference in the recurrence rate after open surgery in the group(P> 0.05).and the difference was statistically significant.The recurrence was compared in different stages,which was obtained in the control group(P <0.05).The rates were different,and the recurrence rate in stage ⅡA1 was higher than that in stages IA2 and IB1.There was no significant difference in the recurrence rate between different stages in the intervention group(P> 0.05).4.Univariate analysis of the age,intervention method,clinical stage,pathological type,surgical method,depth of infiltration of muscle layer,vascular tumor thrombus and other factors that may affect recurrence,and the intervention method,clinical stage and vasculature of lobaplatin lavage Tumor plug is a factor that affects the recurrence of cervical cancer.Multivariate analysis shows that the clinical stage is an independent influencing factor for the recurrence of cervical cancer.Conclusions: Peritoneal lavage and retention of lobaplatin after cervical cancer radical resection are safe for patients.It can reduce the recurrence rate in 2 years and prolong progression-free survival.Tumor clinical stage and vascular tumor thrombus are risk factors for recurrence.