Clinical outcomes after cervical conization : a retrospective analysis

DOI Web Site

Bibliographic Information

Other Title
  • 当科における子宮頸部円錐切除術施行症例の臨床的検討
  • トウ カ ニ オケル シキュウ ケイブ エンスイ セツジョジュツ シコウ ショウレイ ノ リンショウテキ ケントウ

Search this article

Description

<p>Cervical conization is the standard procedure for the treatment of high-grade cervical intraepithelial neoplasia (CIN), and its use has increased in the recent years. The purpose of this study was to evaluate the diagnosis, complications, and pregnancy outcomes following conization. This retrospective study included 352 patients who underwent conization for CIN between July 2007 and December 2014. The median age was 38 years (range, 17-72 years), and many patients were in their thirties (39.1%). The median observation period was 32.4 months (range, 1-102 months). A comparison between the conization specimen and preoperative biopsy results showed that the pathological diagnosis agreement rate was 58.5% and the rate of under-diagnosis was 15.6%. Positive margins were found in 36 cases (10.2%), with 12 cases consistent with invasive squamous cell carcinoma. Thirteen of these patients were followed up, out of which one patient relapsed. Negative margins were observed in 291 cases (82.0%), of which three cases relapsed. Per a previous report, the frequency of recurrence is high in cases with positive margins; however, in our study, the finding was not significant (p=0.38). Cervical stenosis occurred in six patients (1.7%), for which cervical dilation was performed under anesthesia. Postoperative bleeding that required suturing under anesthesia occurred in two patients. Twenty-nine patients carried on pregnancy and 13 patients were treated for threatened premature delivery. There were two cases of spontaneous miscarriage and seven cases of premature delivery. Premature preterm rupture of membranes occurred in six patients. Seven patients were diagnosed with chorioamnionitis based on the placental pathology. In our study, the diagnosis agreement rate was higher and the recurrence rate was lower than the previous reports. However, the pregnancy outcomes were worse than the previous reports. To avoid CIN recurrence and reduce the complications during future pregnancies, it is necessary to choose the excision range appropriately for patients in the reproductive age. [Adv Obstet Gynecol, 70 (1) : 11-16, 2018 (H30.2)]</p>

Journal

Keywords

Details 詳細情報について

Report a problem

Back to top