Current Concepts of Cervical Conization / 대한산부인과학회지
Korean Journal of Obstetrics and Gynecology
; : 2045-2056, 2005.
Article
de Ko
| WPRIM
| ID: wpr-102617
Bibliothèque responsable:
WPRO
ABSTRACT
Conization is defined as excision of a cone-shaped or cylindrical wedge from the cervix uteri that includes the transformation zone and all or a portion of the endocervical canal. It is used for the definitive diagnosis of squamous or glandular intraepithelial lesions, for excluding microinvasive carcinomas, and for conservative treatment of cervical intraepithelial neoplasia (CIN). Techniques for diagnostic and therapeutic conization are virtually identical. The extent of excision must be adjusted according to individual needs. Conization can be performed with a scalpel (cold-knife conization), laser, or electrosurgical loop. The latter is called the loop electrosurgical excision procedure (LEEP) or large loop excision of the transformation zone (LLETZ). Combined conization usually refers to a procedure started with a laser and completed with a cold-knife technique. Laser conization can be excisional or destructive (by vaporization). Each of these approaches has distinct benefits and disadvantages. Cold-knife conization provides the cleanest specimen margins for further histologic study, but it is typically associated with more bleeding than laser or LEEP, and it requires general anesthesia in most cases. Laser procedures are of longer duration and, especially if low-power density is used, may "burn" the margins, thus interfering with histological diagnosis. The main advantage with this procedure is that dots produced by the laser energy can be used to accurately outline the exocervical margins. However, overall, the benefit of using laser for conization may not justify the high cost of the procedure. LEEP procedures have several advantages, including rapidity, preservation of the margins for histological evaluation, and virtual bloodlessness. Moreover, one can perform LEEP procedures in the office or in other outpatient settings.
Mots clés
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Patients en consultation externe
/
Dysplasie du col utérin
/
Col de l'utérus
/
Conisation
/
Diagnostic
/
Hémorragie
/
Anesthésie générale
Type d'étude:
Diagnostic_studies
Limites du sujet:
Female
/
Humans
langue:
Ko
Texte intégral:
Korean Journal of Obstetrics and Gynecology
Année:
2005
Type:
Article