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Objective To explore the influence on intraoperative hemorrhage and relative complications of temporary balloon occlusion of the abdominal aorta in cesarean section for the pernicious placenta previa and placenta accreta.Methods One hundred and thirty-four cases of pernicious placenta previa and placenta accrete from January 2011 to January 2016 were analyzed retrospectively.Before the cesareans,temporary balloon occlusion in abdominal aorta was carried out in 69 patients (observation group).The other 65 patients didnt get the balloon occlusion in abdominal aorta (control group).The situation during and after the operation and relative complications were compared.Results The operation duration [(65.2 ± 6.3)min vs (93.2 ±8.8)min],postpartum hemorrhage [(923.2 ± 188.6)ml vs (2 791.8 ±336.2)ml],intraoperative blood transfusion [(423.7 ±59.3)ml vs (1 581.6 ±68.3)ml],the prothrombin time during the operation [(9.3 ± 1.1) s vs (12.4 ± 1.5) s],the hysterectomy rate [0 vs 7.7％ (5/65)],hospitalization time [(5.2 ±0.9)d vs (6.8 ± 1.1)d],and the rate of transferring to intensive care unit [1.4％ (1/69) vs 12.3％ (8/65)] in the observation group were lower than control group,with a statistical significant difference (P ＜ 0.05).There was no significant difference between two groups in Apgar score and birth weight of the neonate (P ＞ 0.05).Conclusions Temporary balloon occlusion of the abdominal aorta in cesarean section is a safe and effective technique,which can reduce the relative complications,such as the volume of bleeding and the risk of hysterectomy.
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ObjectiveTo investigate the clinical value of routine para - aortic lymphadenectomy in patients with stage Ⅰ B1 and Ⅱ A2 cervical cancers treated by surgical intent.Methods240 patients with stage Ⅰ B1 and Ⅱ A2 squamous cervical cancer were randomly divided into tow groups( group A and B).120 patients (group A) underwent radical hysterectomy with systematic pelvic lymphadenectomy and paraaortic lymphadenectomy.Other 120 patients (group B) underwent radical hysterectomy with systematic pelvic lymphadenectomy,additional para-aortic lymphadenectomy were carried out when para-aortic lymph nodes were identified as suspicious by visualization and palpation.The operation time,amount of surgical bleeding,length of stay,complications,and metastasis rates of pelvic lymph node,metastasis rates of common iliac lymph node and metastasis rates of para-aortic lymph node were analyzed between two groups.ResultsThe clinical characteristics of the patients had no statistically significant difference between the two groups.The length of stay and the complications of group A were significantly higher than group B ( P ＜0.05 ).During the 240 patients,the metastasis rates of pelvic lymph node,common iliac lymph node and para-aortic lymph node were 27.9％,10.8％ and 5.4％.The metastasis rate of para-aortic lymph node in group A was statistically higher than that in group B( 8.3％ vs 2.5％,P ＜0.05),whereas there had no significant difference of the metastasis rates of pelvic lymph node and common iliac lymph node between the two groups.ConclusionsRoutine para-aortic lymphadenectomy can be helpful to accurately predict the status of the para-aortic lymph node in patients with stage Ⅰ B1 and Ⅱ A2 cervical cancer,but the length of stay and the complications of operation will increase.