Analysis On Risk Factors For Postoperative Lower Limb Lymphedema In Patients With Cervical Cancer In Stage Ib-?A

Objective:This study aims to explore the incidence of postoperative lower limb lymphedema and its related risk factors in patients with cervical cancer in Stage 2009 FIGO IB-IIA,so as to provide a powerful theoretical reference for taking targeted nursing and prevention measures to high-risk patients,in order to improve the postoperative quality of life of patients.Methods:Clinicopathological data of patients with cervical cancer in Stage 2009 FIGO IB-IIA treated by gynecologic surgery in Jiangxi Provincial People's Hospital from May 2014 to May 2019 were collected,and 173 patients met the inclusion criteria.The study objects were divided into lower limb lymphedema group and no lower limb lymphedema group according to the presence or absence of postoperative lower limb lymphedema.The correlation between age,body mass index,number of resected lymph nodes,FIGO stage,adjuvant radiotherapy and chemotherapy,positivity of lymph nodes,lymphatic vessel space infiltration,surgery mode,pathological type factors of the two groups and the occurrence of lower limb lymphedema was analyzed,and the independent risk factors of lower limb lymphedema were determined by Chi-square test and multi-factor unconditional logistic regression analysis,with P(27)0.05 indicating statistically significant difference.Results:1.Among 173 patients included in the study,40 cases were in the lower limb lymphedema group which had an incidence rate of lower limb lymphedema of 23.1%,and 133 cases were in the no lower limb lymphedema group.2.Stage of severity of lower limb lymphedema: 13 cases(32.5%)in Stage I,25cases(62.5%)in Stage II and 2 cases(5%)in Stage III.3.The incidence rate of lower limb lymphedema in patients with cervical cancer in Stage 2009 FIGO IB-IIA undergoing both radical surgery and postoperative adjuvant radiotherapy and chemotherapy was 32%,while the incidence rate of lower limb lymphedema in patients undergoing radical surgery only was 14.3%.4.Single-factor analysis of the two groups of objects showed that the number of resected lymph nodes above 20,adjuvant radiotherapy and adjuvant chemotherapy were related to the occurrence of lower limb lymphedema(P(27)0.05),while age,body mass index,FIGO stage,positivity of lymph nodes,lymph vessel space infiltration,surgery method and pathological type factors had no statistical significance(P(29)0.05).Multi-factor unconditional logistic regression analysis showed that the number of resected lymph nodes above 20(OR=2.934,95%CI:1.372-6.278)was an independent risk factor for lower limb lymphedema,and the risk of lower limb lymphedema in patients with more than 20 resected lymph nodes was 2.934 times higher than that in patients with 20 or less resected lymph nodes.Conclusion:1.Lower limb lymphedema was one of the common complications after radical surgery in patients with cervical cancer in Stage 2009 FIGO IB-IIA.Lymphedema degree is most common in Stage II(62.5%).2.The number of resected lymph nodes above 20 was an independent risk factor for lower limb lymphedema in patients with cervical cancer with in Stage 2009 FIGO IB-IIA after radical surgery.3.Patients shall be informed of the possibility of lower limb lymphedema before surgery and appropriate preventive education shall be carried out for the patients.Sentinel lymph node biopsy was feasible during surgery.Indications of adjuvant radiotherapy and chemotherapy shall be controlled strictly after surgery to minimize the incidence of lower limb lymphedema.