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Objective:To compare the clinical efficacy of cold knife conization and transcervical resection of cervical lesion in the treatment of cervical intraepithelial neoplasia(CIN) Ⅱ,Ⅲ.Methods:The clinical data of 62 patients with CIN Ⅱ,Ⅲ underwent cold knife conization(CKC group) and 114 underwent transcervical resection of cervical lesion(TCRC group)in Zhujiang Hospital Southern Medical University from Jan 1 st 2010 to Jun 1 st 2014 were collected.The patients' age,pregnant frequency,mean operative time,preoperative pathological grading,blood loss during the operation and after the operation,positive resected margin,cervical stenosis and recurrence were compared between the two groups.Results:There was no difference on the patients age,pregnant frequency and preoperative pathological grading between the two groups(P ＞ 0.05).The mean blood loss during the operation (14.16 ± 14.10 ml)and the mean hospital stays(5.73 ± 1.43 days)of CKC group were significantly different from those of TCRC group(29.80 ±20.55 ml,4.75 ±1.23 days) (P＜0.05).There was no statistical difference on the mean operation time,postoperative vaginal bleeding rate,rate of positive resected margin,cervical stenosis rate and recurrence rate between CKC group and TCRC group (33.15 ± 11.42 min vs 33.18 ±14.61 min,33.9％ vs 21.1％,3.2％ vs 5.3％,4.8％ vs 4.4％,4.8％ vs 3.5％,respectively) (P＞0.05).The concordance rate of pre-operation and post operation pathological results of CKC group and TCRC group was 74.2％ (46/62) and 72.8％ (83/114) respectively,both kappa values were ＜ 0.75.Conclusions;Both CKC and TCRCT are safe as well as effective in the treatment of high-grade cervical intraepithelial neoplasia.Compared with CKC,TCRC has the advantage of short hospital stay,while much intraoperative blood loss,which calls for intraoperative attention.
ABSTRACT
Objective To compare the efficacy of transcervical resection(TCRC)and loop electrosurgical excision procedure(LEEP)for the treatment of cervical intraepithelial neoplasia grade I(CINⅠ).Methods A total of 231 CIN I patients were divided into two groups according to their patient number to receive TCRC or LEEP.The resected specimens were sent for pathological diagnosis and human papilloma virus(HPV)-16/18 test.Results No significant difference was found in the operation time[(14.1?2.2)min vs.(13.8?2.1)min],rates of wound infection and cervical stricture[1.7%(2/115)vs.1.7%(2/116)and 0.9%(1/115)vs.1.7%(2/116)],and rates of cure and recurrence [99.1%(107/108)vs.99.1%(108/109)and 0.9%(1/108)vs.0.9%(1/109)] between the TCRC and LEEP groups(t=1.060,P=0.290;?2=0.000,P=1.000;?2=0.000,P=1.000;?2=0.000,P=1.000;?2=0.000,P=1.000).In the TCRC group,the surgical wound was healed in(5.0?0.6)weeks,which was significantly shorter than that in the LEEP group[(5.2?0.7)weeks,t=-2.331,P=0.021].The patients who had severe endocervicitis in both the groups had similar rate of residual endocervicitis[16.7%(2/12)vs.53.8%(7/13),Fisher's test:P=0.097].In both the groups,one patient respectively showed residual lesion after the procedure,in whom HPV-16 and/or HPV-18 were detected.Conclusions Both TCRC and LEEP are effective for CINI.LEEP is easier to master than TCRC.Closed follow-up is essential of the with patients positive HPV-16 or-18.
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Objective To compare the therapeutic effects of transcervical resection(TCRC) and loop electrical excision procedure(LEEP) for the treatment of moderate-to-severe chronic cervicitis.MethodsFrom January 2003 to July 2006,totally 520 patients with moderate-to-severe chronic cervicitis were randomly divided into two groups to receive TCRC or LEEP.ResultsThe intraoperative blood loss in the TCRC group was significantly less than that in the LEEP group [(4.2?1.3) ml vs(10.1?4.5) ml,t=-20.310,P=0.000].Whereas,no significantly differences were found in the drainage and bleeding time and cure rates between the two groups [(15.9? 3.7) d vs(16.2? 3.3) d,t=-0.976,P=0.330;and 95.2%(236/248) vs 93.2%(235/252),?2=0.832,P=0.362].ConclusionsBoth TCRC and LEEP are effective for chronic cervicitis.TCRC is superior to LEEP in the surgical outcomes;however the latter is easier to perform than TCRC.