Analysis Of Factors Related To Formation Of Lymphocyst After Pelviclymphadenectomy

Objective:To explore the relevant factors related to the formation of lymphocyst after pelvic lymphadenectomy inpatients with gynecological malignancies,to guide the prevention and treatment of lymphocyst.Methods:The 530 patients with cervical cancer 、 ovarian cancer or endometrial cancer who underwent pelvic lymphadenectomy and/or para-aorticlymphadenectomy in the Affiliated Hospital of Qingdao Universityfrom May 2019 to April 2020 as the study subjects.Collecting preoperative 、intraoperative 、 postoperative clinical data of them,specifically including: type of tumor 、 age of patients 、 body mass index(BMI)、 whether adjuvant chemotherapy or not、 abdominal surgery history、 blood glucose、 blood pressure、 blood lipids、surgical method、whether omental resected or not、whetherretroperitoneumshut down or not、whether use hemostatic materials、duration of surgery、the number of resected lymph nodes、amount of intraoperative bleeding、scope of lymphadenectomy、the methods of close the broken ends of lymphatic vessels、drainage tube indwelling mode、differentiation of tumor cells、lymph node metastasis、 International Federation of Gynecology and Obstetrics(FIGO)pathological stage 、 tumor thrombus 、 volume of drainage 、 drainage time 、postoperative hemoglobin concentration、postoperative albumin concentrationand the clinical manifestations 、 treatmentandcurative effect of patients with lymphocyst.Through the collected clinical data,the incidence of lymphocyst was counted.A total of 530 patients were divided into lymphocyst group and non-lymphocyst group,and the correlation between the formation of lymphocyst after lymphadenectomy and the collected factors was analyzed by statistical software and methods.Results:1.The overall incidence of lymphocystwas 38.87 %(206 / 530),of which 77.18 %(159 / 206)were asymptomatic,22.82 %(47 / 206)were symptomatic,and the overall incidence of symptomatic lymphocyst was 8.9%(47 / 530).2.The univariate analysis showed that after lymphadenectomy in patients with gynecological malignant tumors,the influencing factors related to the formation of lymphocyst are as follows : type of tumor 、 surgical method 、 FIGO pathological stage,preoperative chemotherapy、the number of resected lymph nodes、differentiation of tumor cells、the methods of close the broken ends of lymphatic vessels、whether retroperitoneum shut down or not、whether omental resect or not、lymph node metastasis、duration of surgery、postoperative Hb concentration、postoperative Alb concentration、drainage tube indwelling mode、total drainage volume of drainage tubeand metabolic syndrome(MS)(P< 0.05).3.Multivariate analysis showed that:(1)the number of resected lymph nodes 、whetherretroperitoneumshut down or not 、metabolic syndrome 、the methods of close the broken ends of lymphatic vessels and postoperative hypoproteinemiaare the independent influencing factors of the formation oflymphocyst(P<0.05).(2)retroperitoneal closure 、metabolicsyndrome 、 postoperative hypoalbuminemiaare risk factors for the formation oflymphocyst;(3)Using ultrasonic scalpe is a protective factor for the formation of lymphocyst.4.The cure rate of antibiotic combined with ultrasound-guided percutaneous puncture and drainage was 93.62 %.Conclusion:1.The large number of lymphadenectomy、 retroperitoneal closure、 combined with metabolic syndrome and postoperative hypoalbuminemia can increase the risk of the formation of lymphocyst.2.The application of ultrasonic scalpel can reduce the risk of the formation of lymphocyst.3.Antibiotics combined with ultrasound-guided percutaneous puncture drainage and catheter drainage are effective measures for the treatment of lymphocyst.combined with ultrasound-guided percutaneous aspiration or tube drainage is an effective treatment for lymphocyst.