Risk Factors Analysis And Treatment Of Lymphatic Leakage After Radical Cystectomy

Objective: To explore the causes of lymphatic leakage after radical cystectomy,and to study the role of various factors in the prevention and treatment of lymphatic leakage.Method: The clinical data of 150 patients who underwent radical cystectomy in the Department of Urology,Yanbian Hospital from January 2005 to December 2021 were selected.A retrospective comparative study was performed on the clinical data of patients with laparoscopic radical cystectomy(LRC)and open radical cystectomy(ORC),including 81 cases in the LRC group and 69 cases in the ORC group.After the standard of our hospital was established,the patients were divided into lymphatic leakage group(n=37)and non-lymphatic leakage group(n=113),and the related factors of postoperative lymphatic leakage were analyzed,including the ethnicity,gender,age,and length of hospitalization of the patients.,number of lymph nodes dissected,number of positive lymph nodes,extent of lymph node dissection,presence or absence of positive lymph nodes,intraoperative blood loss,body mass index(BMI),preoperative and postoperative hemoglobin(Hb),postoperative albumin(ALB),surgery Methods and other clinical data were used,and SPSS 21.0 statistical software was used for univariate and multivariate statistical analysis of the two groups of data.Results:1.A total of 150 patients with radical cystectomy were included in this study,of which 37 patients(24.7%)were diagnosed with lymphatic leakage.2.The univariate analysis of the formation of lymphatic leakage showed that the number of lymph nodes dissected,the number of positive lymph nodes,the presence or absence of positive lymph nodes,and the surgical method had statistical significance with the occurrence of lymphatic leakage(all P<0.05),while ethnicity,gender,age,length of stay in hospital were statistically significant.,lymph node dissection range,intraoperative blood loss,body mass index,preoperative and postoperative hemoglobin,postoperative albumin and lymphatic leakage were not statistically significant(all P>0.05).3.The multivariate binary Logistic regression analysis of the formation of lymphatic leakage showed that the number of lymph nodes dissected,the extent of lymph node dissection,the amount of postoperative hemoglobin and the occurrence of postoperative lymphatic leakage were statistically significant(all P<0.05),which was the postoperative lymphatic leakage There were no independent risk factors for the occurrence of the disease,but there were no statistically significant differences in ethnicity,gender,age,length of hospital stay,number of positive lymph nodes,presence or absence of positive lymph nodes,intraoperative blood loss,body mass index,preoperative hemoglobin,postoperative albumin,and surgical methods.(all P>0.05).Conclusion:The number of lymph node dissections,the extent of lymph node dissection and the amount of postoperative hemoglobin were the independent risk factors for the occurrence of postoperative lymphatic leakage after radical cystectomy.Through skilled surgical skills,familiarity with anatomical sites,fine intraoperative operations and correction of postoperative anemia,the incidence of postoperative lymphatic leakage can be reduced.