Related Research Of Lymphocysts And Infection After Pelvic Lymphadenectomy Of Gynecologic Malignant Tumor

Objective:The discussion of the related factors and treatments of postoperative pelvic lymphocyst formation and infection after lymphadenectomy of the gynecologic malignant tumor.Methods:Choose from June 2013 to June 2016 in Shanxi Province tumor hospital was diagnosed with the gynecologic malignant tumor of clinical and pathological data of498 patients,correlation analysis.According to the presence of lymphocyst formation can be divided into lymphocyst group and no lymphocyst group.Analysis of patient age,tumor type,presence of diabetes history,the methods of close the lymphatic vessel,retroperitoneum shut down or not,which leads to the way the drainage tube,postoperative anemia,low platelet,hypoalbuminemia,abnormal liver function and postoperative pathological conditions,the indwelling drainage tube time,postoperative factors such as traffic,24 hours a day,and lymph cyst formation,and the correlation of infection.We used the statistical analysis such as the x2 test results and Fisher's exact probability method and logistic regression model.Results:1.Using the x2 test were compared between the two groups showed that the formation of pelvic lymphocyst and the methods of close the lymphatic vessel,retroperitoneal closed or not,the way of drainage,postoperative hypoproteinemia,liver function is abnormal and the number of resected lymph nodes,drainage time,postoperative 24 hours lead flow(P < 0.05);However,there was no significant correlation with age,tumor type,history of diabetes mellitus,postoperative anemia,postoperative thrombocytopenia and the number of metastatic lymph nodes(P > 0.05).2.Using Logistic regression correlation analysis results showed that:(1)The methods of close the lymphatic vessel,retroperitoneal approach and the number of resected lymph nodes are independent risk factors for lymph cyst formation(P < 0.05),and postoperative hypoproteinemia,abnormal liver function,independent risk factors of indwelling drainage time and not lymphocysts(P > 0.05);(2)The risk of formation of the cyst was increased by a factor of 1.423(OR = 1.423)compared the sharp and blunt tearing with using the ultrasonic scalpel;(3)Opening retroperitoneal is a protective factor for the formation of lymphocyst(B-0.747);(4)The greater the number of lymph node excision,the greater the risk of the formation of the lymph node,the number of resected lymph nodes each increased by 10,the risk of the formation of the lymphatic cyst increased by a factor of 1.396(OR = 1.396).3.The major pathogens of lymphocyst infection were Escherichia coli,accounted for57.69%.Using the x2 test analyze the relationship between the infection of lymphocyst and the diameter of lymphatic cyst,the occurrence of bilateral,drainage tube and the time of indwelling drainage tube(P < 0.05).Using Fisher exact probability method is relatively simple antibiotics(efficiency of 28.57%)and combined with ultrasound guided puncture and drainage of lymphocyst(71.43% efficiency)effect of Lymphocyst infection treatment,the difference was statistically significant(x2=12.857,P < 0.05).Conclusion:1.The incidence of postoperative lymphocyst could be increased by using ultrasonic scalpel to close the lymphatic vessel;2.Open retroperitoneal can reduce the incidence of lymphocyst;3.The more the number of resected lymph nodes,the more the risk of the formation of lymphocysts;4.The main pathogens were Escherichia coli of lymphocyst infection,and with a greater volume of cyst(>5cm),bilateral,drainage tube vaginal leads and long time is closely related to indwelling;antibiotic therapy combined with ultrasound guided puncture and drainage are effective measures for treating lymphatic cyst infection.