Risk Factors Associated with Intraoperative Blood Loss in Patients with Early Cervical Cancer

Objective To determine risk factors associated with intraoperative blood loss in patients with early cervical cancer (stage ⅠB-ⅡA). Methods The medical records of 892 patients who underwent surgical treatments for early cervical cancer in the Second West China University Hospital of from Dec 2010 to Sep 2017 were retrospectively reviewed: 127 having ≥500 mL intraoperative blood loss patients compared with 765 less than 500 mL. Differences between the two groups in age, body mass index (BMI), gravidity, history of abdominal and pelvic operations, chronic pelvic inflammation disease, clinical stage, methods of operation, neoadjuvant chemotherapy (NACT) and post-NACT operative opportunity, preoperative and postoperative hemoglobin, and intraoperative transfusion volume were analyzed through univariate and multivariate statistical methods. Results The univariate analyses identified age, BMI, gravidity, history of abdominal and pelvic operation, chronic pelvic inflammation disease, clinical stage, methods of operation, NACT and post-NACT operative opportunity assignificant factors associated with intraoperative blood loss ( P＜0.05). The multivariate logistic regression analysis confirmed that age ≥40 yr. 〔partial regression coefficient (B)=2.100)〕, BMI ≥24 kg/m² (relative to 18.5-23.9 kg/m²)(B=1.842）, clinical stage ⅡA（relative to phase ⅠB, B=2.401）, trans-abdominal operative method （relative to laparoscopy, B=1.347), no NACT （B=1.540） and post-NACT operative opportunity <2 or >3 weeks (relative to within 2-3 weeks) (B=1.723） were independent predictors of higher intraoperative blood loss (≥500 mL). Conclusion Clinical stage and age, etc. are risk factors associated with intraoperative blood loss in patients with early cervical cancer.