Factors affecting operative blood loss from open radical hysterectomy and pelvic lymphadenectomy for early-stage cervical cancer
Factors affecting operative blood loss from open radical hysterectomy and pelvic lymphadenectomy for early-stage cervical cancer
复制标题
DOI：
10.1007/s00404-012-2387-2
复制
发表时间：
2012-10-01
影响因子：
2.6
通讯作者：
Charoenkwan, Kittipat
中科院分区：
文献类型：
--
作者：
Achavanuntakul, Kajohn;Charoenkwan, Kittipat
探讨临床及肿瘤因素对早期宫颈癌开放式子宫根治术及盆腔淋巴结清扫术出血量的影响。本文回顾性分析了2003年1月至2005年12月间456例io2 - iia期宫颈癌患者行开放性根治性子宫切除术并双侧盆腔淋巴结切除术（RHPL）的临床、病理和手术资料，其中术中出血量≥600ml。多因素分析显示，胎次（RR 1.67; 95% CI 1.02-2.73； p值0.04）和输卵管卵巢切除术（RR 1.57; 95% CI 1.06-2.31； p值0.02）与术中出血量600 ml及以上相关。在多因素分析中，术前化疗（RR 1.87; 95% CI 1.18-2.96； p值< 0.01）和BMI每千日元25 kg/m(2) （RR 1.73; 95% CI 1.08-2.75； p值0.02）与失血量大于1000 ml显著相关。高胎次（3次或以上）和偶然的输卵管卵巢切除术与开放性RHPL术中出血量增加600毫升或更多有关。然而，这些影响是边际的，对潜在的机制也没有明确的解释。术前化疗和超重是手术失血量大于1000 ml的独立预测因素。
To evaluate the effect of clinical and tumor factors on operative blood loss during open radical hysterectomy and pelvic lymphadenectomy for early-stage cervical cancer.Clinical, pathological, and operative data of 456 women with cervical cancer stage IA2-IIA who had open radical hysterectomy with bilateral pelvic lymphadenectomy (RHPL) from January 2003 to December 2005 were reviewed with regard to operative blood loss of 600 ml or more.Parity (RR 1.67; 95 % CI 1.02-2.73; p value 0.04) and salpingo-oophorectomy (RR 1.57; 95 % CI 1.06-2.31; p value 0.02) were statistically associated with operative blood loss of 600 ml or more from multivariate analysis. Preoperative chemotherapy (RR 1.87; 95 % CI 1.18-2.96; p value < 0.01) and BMI a parts per thousand yen 25 kg/m(2) (RR 1.73; 95 % CI 1.08-2.75; p value 0.02) were significantly associated with blood loss of more than 1,000 ml in the multivariate analysis.High parity (3 or more) and incidental salpingo-oophorectomy are related to an increased risk of operative blood loss of 600 ml or more during open RHPL. However, the effects were marginal and no clear explanation for the underlying mechanisms is available. Preoperative chemotherapy and overweight were independent predictors of operative blood loss of more than 1,000 ml.