Analysis Of Risk Factors Of Postoperative Complications In Endometrial Carcinoma

Objective: This study aimed to investigate the incidence of postoperative complications in patients with endometrial cancer and investigate the effects of postoperative complications by retrospective analysis of patients with endometrial cancer undergoing initial surgery.To explore the influencing factors associated with postoperative complications and provide theoretical basis for perioperative management of endometrial cancer.Methods: The pathological diagnosis of the Fourth HosPital of Hebei Medical University from January 1,2008 to December 31,2017 was diagnosed as endometrial cancer and initial surgery was performed(only under hysteroscopic endometrial resection)except for 2906 patients,the retrospective analysis of the data,detailed examination of the patient's clinical and pathological data and the establishment of Excel database.SPSS 21.0statistical software was used to perform statistical analysis on the data collected.Chi-square test was used for univariate analysis.Multivariate analysis was performed using multivariate logistic regression analysis.P<0.05 was statistically significant.Result:1.A total of 2,906 patients with endometrial cancer were included in this study.There were 247 postoperative complications occurring at an incidence of 8.5%;14 patients had at least 2 or more complications.Postoperative fever was the most frequent complication,with a total of 79 cases(32.0%,79/247);followed by lymphocele,a total of 78 cases(31.6%,78/247);the third was intestinal obstruction,a total of 25 cases(10.1%,25/247).Other complications included poor vaginal stump healing(stunt infection,stump bleeding),poor abdominal wound healing,urinary retention,postoperative abdominal hemorrhage,vesico-vaginal fistula,and pulmonary infection.Cerebral infarction,pulmo-nary embolism,ureteral fistula and so on.2.Systemic pelvic and para-aortic lymphadenectomy was more effective than no lymphadenectomy and pelvic lymphadenectomy.The operation time was longer,the amount of intraoperative blood loss was larger,and the percentage of patients who had intraoperative blood transfusions increased,but the number of lymph node dissections increased.3.Patients with postoperative complications had a long operative time,a large amount of intraoperative blood loss,a large range of lymph node resection,and a large number of resected lymph nodes.Laparotomy has a higher risk of complications than laparoscopic surgery.postoperative complications and age,body mass index,preoperative complications,type of hysterectomy,FIGO stage,myometrial invasion,attachment metastasis,lymph node metastasis,and postoperative risk factors significant correlation.4.Age,body mass index,preoperative complications,type of hysterectomy,operation time,intraoperative blood loss,lymph node resection range,number of lymph node dissection,surgical approach,FIGO surgical staging,myometrial invasion,attachment transfer multivariate logistic regression analysis of lymph node metastases and risk factors revealed that long surgical time,systematic pelvic and para-aortic lymph node dissection were risk factors for postoperative complications.Conclusion:1.The common postoperative complications of endometrial cancer patients are postoperative fever and lymphocele.2.Patients with pelvic and para-aortic lymphadenectomy have an increased incidence of postoperative fever and lymphocele.3.Surgical methods,lymph node resection range,number of lymph node resections,intraoperative blood loss,and operation time were related to the occurrence of postoperative complications in patients with endometrial cancer.Prolonged operative time(>4 hours)and systematic pelvic and para-aortic lymph node dissection are risk factors for postoperative complications.