[Ultrasonographic evaluation of the uterine cervix length remaining after LOOP-excision]. / Évaluation échographique de la longueur de col utérin restant après conisation par électrorésection.

OBJECTIVES: To assess whether there is a correlation between the length of a conization specimen and the length of the cervix measured by vaginal ultrasonography after the operation PATIENTS AND METHODS: Prospective observational study including patients less than 45 years with measurement of cervical length before and the day of the conization, and measuring the histological length of the specimen. RESULTS: Among the 40 patients enrolled, the average ultrasound measurements before conization was 26.9 mm (± 4.9 mm) against 18.1mm (± 4.4mm) after conization with a mean difference of 8.8mm (± 2.4mm) (difference statistically significant P<.0001). The extent of histological specimen was 9 mm (± 2.2mm) on average. A correlation between ultrasound and histological measurements with a correlation coefficient R=0.85 was found statistically significant (P<0.0001). Moreover, the rate of cervix length remove by loop-excision in our series is 33% (± 8.5%). DISCUSSION: A good correlation between the measurements of the specimen and the cervical ultrasound length before and after conization was found, as a significant reduction in cervical length after conization. The precise length of the specimen should be known in case of pregnancy and the prevention of prematurity due to conization rests on selected indications and efficient surgical technique.

Toward a real-time tracking of a medical deformable needle from strain measurements.

Needles used in medical percutaneous procedures are brought to deform because of its interactions with inhomogeneous and anisotropic tissues. In this paper, the first step of the development of a new generation of tools for assistance in the realization of gestures taking into account these deformations are presented. We provide a new approach for determining, in "real time" and in 3D, the shape of an instrumented needle inserted into a complex tissue by using strain microgauges. The knowledge of the real time local deformation from these strain microgauges would improve the current navigation systems by considering not only the rigid needles but also the flexible ones. Our aim is to reconstruct in real time the instrumented needle shape in order to help tracking and steering during a medical intervention.

[Adenocarcinoma of the uterine cervix: particularities in diagnosis and treatment]. / L'adénocarcinome du col utérin : particularités diagnostiques et thérapeutiques.

INTRODUCTION: The adenocarcinoma of the uterine cervix accounts for 10 to 20% of the premalignant and malignant lesions and is different from the cervical intraepithelial neoplasia and invasive squamous cell carcinoma. MATERIALS AND METHODS: Recent literature review (from 1985 to 2012) based on the literature available. RESULTS AND DISCUSSION: Adenocarcinoma in situ is an induced HPV lesion (role of HPV 18) of the glandular epithelium: its preferential endocervical situation explains the difficulties in the diagnosis and follow-up after conservative treatment. If the hysterectomy remains the gold standard for treatment, the conservative treatments (resection in sano of the lesions with margins of more than 1cm, meticulous study of the operative specimen, compliance with the follow-up) are possible in the young patients who desire to preserve their fertility. The invasive adenocarcinoma is characterized by a more difficult diagnosis because of its endocervical development, and a prognosis less favorable when compared to squamous cell carcinoma with a greater frequency of the lymphatic node involvement and metastatic diffusion. Its treatment must take into account the particular gravity of the factors of worse prognosis (FIGO stage, tumor size, lymphatic node spreading, adenosquamous histological subtype) in particular in the advanced stages and includes beside the surgery, radiotherapy and chemotherapy.