ABSTRACT
Objective@#To investigate the clinical effect of cervical conization under cervical endoscopy in high-grade cervical intraepithelial neoplasia (CIN).@*Methods@#From June 2017 to June 2019, 100 patients with grade II and III CIN admitted to Harbin First Hospital were divided into control group and observation group with 50 cases in each group by random number table method.The control group was treated with traditional cervical cold knife conization, while the observation group was treated with cervical conization under endoscopy.To compare the therapeutic effects of two surgical methods.@*Results@#The incidence of positive margin were significantly lower than that in the control group(8%(4/50) and 18%(9/50)), and the difference was statistically significant (χ2=4.98, P<0.05). The postoperative follow up was proceed one year.The incidence of cure were significantly higher than that in the control group(96%(48/50)vs.84%(40/50)), and the residual rate and recurrence rate were lower than that of the control group(6%(3/50) and 14%(7/50), 2%(1/50)and 8%(4/50)), the difference was statistically significant (χ2=10.56, 3.98, 13.96, all P<0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group [6% (3/50) and 18% (9/50)], the difference was statistically significant (χ2=11.25, P<0.05). There was no significant difference in bleeding volume, operation time and wound healing time between the two groups (t value was 1.46, 1.26 and 0.98 respectively, all P>0.05).@*Conclusion@#The cervical conization through cervical canal endoscope can accurately locate the focus of high-grade CIN, with higher rate of lesion clearance, lower rate of lesion recurrence and complications.
ABSTRACT
Objective To explore the value of diagnosis and treatment of conization of cervix to cervical intraepithelial neoplasia(CIN)Ⅱ-Ⅲ grade.Methods The data of 76 patients diagnosed as CIN Ⅱ-Ⅲ grade through pre-operative multiple-punch biopsies from July 1st 2006 to June 30th 2007 was retrospectively analyzed.Compared the pathohistology and treatment methods before and after conization of cervix.Results Accordance rate of diagnosis in pre-operative cervical biopsies under vaginoscopy was 48.68%,pathological up-grade were 24 cases(31.58%),among invasive carcinomas were 8 cases(10.53%),pathological down-grade were 15 cases(19.74%).Conclusion Diagnostic cervical conization could enhance the rate of diagnosis,and prevent the omission of invasive carcinomas for the patients with CIN Ⅱ-Ⅲ grade.
ABSTRACT
Background and purpose:Cervical conization, including high frequency loop electrosurgical excision procedure(LEEP) has been widely used in the treatment of cervical diseases, but how to deal with the patients with pathological positive margin is a problem for clinicians.The purpose of this study was to discuss the option of adjuvant treatment after cervical conization with positive margins for patients with cervical neoplasm.Methods:The data of 528 patients who had cervical conization from 1998 to 2008 was reviewed, among which 54 patients with pathological positive margin was retreated and analyzed.Results:Fifty-four patients were divided into observation group and treatment group, 17 cases were in observation group and 37 cases in treatmeat proup.The recurrence / duration / progress rate was 17.6%(3/17), in treatment group it was 2.7%(1/37) in observation.CINⅠ-Ⅱ positive margins in both group had no recurrence;among 14 patients with CINⅢ, 1 lesion persisted, and 1 progressed to cervical squamous cell carcinoma, none in treatment group was recurrent;For those 10 patients with micro-invasive margin-positive cases, 1 progressed to squamous cell carcinoma, the remaining 9 cases were followed up for 26 months without recurrence after operation.One case in invasive cancer group had recurrence.Conclusion:The patients with CINⅢ margin-positive patients after conization should receive individualized treatment.The patient with microinvasive carcinoma should be retreated with either re-conization or hysterectomy;if with margin-positive CINⅢ after conization, or re-conization or directly treated according to guideline addressing for ⅠB, if margin showed microinvasive carcinoma.The patients with margin-positive invasive carcinoma after conization should be treated according to guideline.