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An Analysis of the Effect of Extensive Hysterectomy Combined with Pelvic Lymphadenectomy on Cervical Cancer and the Influencing Factors of Postoperative Pelvic Floor Dysfunction |
LI Yuanyuan, YANG Daping, SUN Yanyan |
Suzhou Municipal Hospital, Anhui Suzhou 234000, China |
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Abstract Objective: To investigate the effect of extensive hysterectomy combined with pelvic lymphadenectomy for cervical cancer, and to analyze the influencing factors of postoperative pelvic floor dysfunction (PFD). Methods: 63 patients with cervical cancer who were treated in our hospital from January 2015 to June 2019 were divided into study group (32 cases) and control group (31 cases) with random table method. All patients underwent extensive hysterectomy combined with pelvic lymphadenectomy. As to reatment, the study group took laparoscopy, and the control group took conventional open surgery. The intraoperative and postoperative conditions and complications were compared between the two groups. Binary logistic regression was used to analyze the risk factors of postoperative PFD. Results: The operation time, intraoperative blood loss, time to get out of bed, anal exhaust time, postoperative defecation time, and hospitalization time of the study group were significantly lower than those of the control group. The number of lymph node dissection in the study group was significantly higher than that of the control group. It is tatistical significance (P<0.05). The complication rate of the study was 56.25%, which was significantly lower than that of the control group (87.10%). The difference was statistically significant (P<0.05). A total of 38 cases of PFD occurred after operation. The factors of age, tumor diameter, presence or absence of ejaculation, and indwelling catheter were the influencing factors of postoperative PFD in patients with cervical cancer (P<0.05). Multivariate binary logistic analysis reveals that age ≥ 45 years, tumor diameter ≥ 4cm, menopausal, urethral catheter indwelling time ≥ 7d were risk factors for postoperative PFD in patients with cervical cancer (P<0.05). Conclusion: Laparoscopic extensive hysterectomy combined with pelvic lymphadenectomy for cervical cancer patients has a good effect, but incidence rate of postoperative PFD is high. Proper measures should be taken to aged menopausal patients whose tumor diameter is too large, and urethral catheter is long indwelled.
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