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PubMed1993

Studies on repair of the uterine cervix after CO2 laser conization with anti-keratin monoclonal antibodies.

Histological repair of the cervical epithelium after CO2 laser conization was studied using resected uterus specimens. (1) Squamous epithelium (ectocervical side) and reserve cells (endocervical side), were seen immediately after conization; (2) HE staining showed that the S-C junction was formed within 4 weeks. (3) Endocervical epithelial repair of the S-C junction tended to be delayed, and the new S-C junction was deeper in the endocervical canal than before conization; (4) The stroma was repaired within 7 weeks, by prompt collagenization.

Adult↗

PubMed1979

Pregnancy and delivery after conization of the cervix.

Of 327 patients who had undergone conization of the cervix in 1968-74 in the Department of Obstetrics and Gynecology, Turku University Central Hospital, 249 replied to a questionnaire. Eighty-nine of these had had total of 112 pregnancies after conization. Conization had only minimal influence on the pregnancies and none on the deliveries. Over 90 per cent of the newborns delivered were full term and without anomalies. The incidence of spontaneous abortions also did not differ from normal.

Abortion, Spontaneous↗

PubMed1992

Clinical evaluation of contact Nd.YAG laser conization for cervical intraepithelial neoplasia of the uterus.

Contact Nd.YAG laser conization (laser cone) was performed in 500 patients with preoperatively diagnosed cervical intraepithelial neoplasia (CIN) since September 1983. The patients treated were followed for 12 to 96 months (39.2 months on average). Average operation time was 11.4 minutes. A cure with laser cone (single treatment) was achieved in 98.6%, including cases with microinvasive and invasive carcinoma, post-operatively. There were only 7 (1.4%) true residual cases of 47 cases (9.4% of total cases) with incomplete excision. High spontaneous cure rates (85.1%) in cases with incomplete excision are considered to be a characteristic of laser cone treatment. The contact laser cone method also got good specimens for histologic examinations. They gave a large amount of information for our follow-up. The results indicate that contact Nd.YAG laser conization for CIN is an excellent conservative therapy from the point of cure rate, safety, indication, operation time and cone specimen, even compared with CO2 laser conization.

Female↗

PubMed1993

Cervical conization and preterm delivery/low birth weight. A systematic review of the literature.

OBJECTIVE: Evaluate the effect of cervical conization on preterm birth/low birth weight (LBW). DESIGN: A systematic review of the literature using external or internal controls. RESULTS: The typical odds ratio for preterm delivery in women with prior cervical conization using external controls was 3.23 (95% confidence interval 2.29-4.55). Using internal controls the typical odds ratio for LBW was 2.97 (95% confidence interval 1.09-8.05). Using external controls the typical odds ratio for LBW was 2.31 (95% confidence interval 1.33-3.99). CONCLUSION: Women with cervical conization are at higher risk for preterm birth than external controls, and the surgical intervention as such is a major determining factor.

Cervix Uteri↗

PubMed2001

Outcomes of carbon dioxide laser conization for the treatment of cervical intraepithelial neoplasia grade III.

PURPOSE: The aim of this study was to determine the rates of incomplete excision of cervical intraepithelial neoplasia (CIN) III after carbon dioxide laser conization, and the risk of reappearance of CIN depending on the excision margins. METHODS: A total of 153 women who underwent carbon dioxide laser conization for CIN III between 1988 and 1998 at our hospitals were eligible for inclusion in the study and their notes were retrospectively studied. RESULTS: Histological examination of the excision margins revealed complete excision in 134 (87.6%), uncertain margins in one, and extension of CIN to the margins in 18 (11.8%) cases. The treatment failure rate in the cases with clear margins was 2.2% (3 of 134), and in the cases with involved margins 44.4% (8 of 18) (p < .001). CONCLUSION: Carbon dioxide laser conization despite the worldwide use of LLETZ still has a place in the treatment of CIN. Very high rates of complete excision were achieved. As incomplete excision does not always result in treatment failure, neither do clear margins always indicate eradication of the disease.

Adult↗

PubMed1992

[Acceptance of ambulatory laser conization under local anesthesia by Danish women].

The aim of the study was to evaluate the acceptability of CO2 laser excisional conization for cervical intraepithelial neoplasia under local anaesthesia in an outpatient setting. Seventy-seven patients, who underwent this procedure, were interviewed three months later concerning pain during treatment, pain and bleeding in the immediate postoperative period, and their general opinion about this procedure. The median duration of surgery was 11 minutes. The postoperative median observation time was 90 minutes. Seventy-one women experienced no discomfort during treatment. Thirty-one patients needed mild analgesics for an average of three days. Bleeding continued for a mean of 7.7 days after treatment and 73% experienced the bleeding as less, 8% as more as compared to menstrual bleeding. Ninety-two percent of the women would prefer this procedure if they had to undergo conization once again. In conclusion, we found a high acceptability in women treated with CO2 laser excisional conization under local anaesthesia in an outpatient setting.

Adult↗

PubMed1992

Effect of CO2 laser conization of the uterine cervix on pathologic interpretation of cervical intraepithelial neoplasia.

The CO2 laser has become a valuable tool for the treatment of lower genital tract neoplasia. The records of 52 women who underwent CO2 laser cervical conization were analyzed retrospectively to evaluate the effect of tissue thermal damage on histopathologic interpretation. Lesion evaluability, defined by the ability to diagnose neoplasia accurately in the specimen, was satisfactory in only 26 cases; in the other 26, thermal damage was severe enough to preclude accurate diagnosis. A postoperative diagnosis of cervical intraepithelial neoplasia III was made in 17 instances, and microinvasion was suspected but unverifiable in two of these. Two patients had frankly invasive cancer, but vascular space involvement in one could not be evaluated accurately because of thermal damage. Tissue thermal damage sufficient to interfere with accurate histologic evaluation was noted in the majority of laser conization specimens. The value of a conization is both diagnostic and therapeutic. The potential impact of a diagnosis compromised by thermal damage is serious.

Adolescent↗

PubMedDate not supplied

[Fertility and pregnancy after conization].

Conization is frequently used as a diagnostic and curative method for the prevention of the cervical cancer on women of the fertile age. Conization was performed on 408 women up to 40 years in our Clinics during the years 1967 to 1989. The percentage of attested postoperative pregnancies among these women amounts to 13.51% and declines with age; it is high among women up to 25 years of age (29%) and low (3%) among women between 36 and 40 years. The percentage with premature births before the operation was 15.25%; after the operation the percentage declined to 13.31%. Preventive cerclage was used on one part (8.1%) of the latter percentage and no cerclage on the remaining 5.4%. It is concluded that there is not high danger of premature birth after conization and therefore performance of the operation does not seem to necessitate preventive cerclage.

Abortion, Spontaneous↗

PubMed1990

Cervical conization findings in women with dysplastic cervical cytology and normal colposcopy.

A review of 134 cervical conizations performed in a 36-month period showed that 18 were performed on patients with two or more cervical smears showing dysplasia but with essentially negative, satisfactory colposcopic evaluations, including normal colposcopically directed biopsies and endocervical curettings. A histologic diagnosis of cervical intraepithelial neoplasia (CIN) of various grades was established in 15 (83%) of the 18 conization specimens. Six (33%) of the 18 specimens harbored CIN 3. The histologic diagnosis of a more severe lesion than that indicated on cytology was rendered in five of the cases. Cervical conization should be performed when colposcopic evaluation of the cervix, vagina and vulva fails to identify the source of persistent CIN on Papanicolaou smears.

Adult↗

PubMed1985

[Analysis of 194 conizations: residual lesions require hysterectomy].

CIN I and CIN II can be treated by colposcopy-guided biopsy. Control examinations must be made every six months. Persistence of a CIN II lesion is an indication for conization. Some CIN III cases can be treated by conization, but considering the frequency of residual lesions and insufficient conization, a total hysterectomy is a safer procedure.

Adult↗

PubMed1978

Comparison of cold conization and directed biopsy.

A study was performed to compare the results of directed biopsy with those of cold conization of the cervix in the private practice community. The intent of the study was to determine whether the two procedures were comparable in accuracy, to compare them in terms of economic impact and to compare the complications of each procedure. The study shows that directed biopsy is as accurate as cold conization of the cervix, is less expensive for the patient and is not fraught with as many serious hazards as is cold conization.

Biopsy↗

PubMed1984

[Preoperative diagnosis for stage II endometrial carcinoma using endocervical conization].

It is generally difficult to identify stage II endometrial carcinoma correctly. To differentiate cervical involvement, endocervical conization was performed on 31 patients with endometrial cancer between May 1982 and September 1983. The preoperative diagnosis of stage II endometrial carcinoma was confirmed by postoperative histologic examination. In stage I patients, there was no microscopic cervical involvement after the operation. Fractional curettage and hysteroscopy are commonly used to detect stage II endometrial carcinoma. However, these examinations may overlook cervical stromal invasion. Endocervical conization is a simple procedure and highly useful to detect cervical stromal involvement. We recommend the of endocervical conization combined with hysteroscopy to diagnose stage II endometrial carcinoma.

Adenocarcinoma↗

PubMed1983

Cure rates after laser conization for early cervical neoplasia.

Follow-up results by vaginal cytology and colposcopy after laser conization for early cervical neoplasia in 333 patients are reported. 95.7% of all the women were free from disease after 4-24 months. The separate figure for very early invasive carcinoma was 96.4% and for CIN III through CIN I it was 96.6%, 94.9% and 90.6% respectively. The cure rate depended on whether or not the resection margins of the cones were free from epithelial cells with atypia. The highest cure rate, 97.8%, was noted for CIN III with margins free from atypical cells. Out of patients not free from disease, 92.9% were detected at the first follow-up at 4--6 months after conization and represent persistent disease. Laser conization seems to give at least as good cure rates as laser vaporization and has the chief advantage that histopathological evaluation is available both for the whole lesion and the resection of the cones. The procedure can be safely performed on an out-patient basis.

Adult↗

PubMed1983

Colposcopically directed conization for frozen-section examination in the management of cervical intraepithelial neoplasia.

We found colposcopically directed conization for frozen-section (F/S) examination to be 100% accurate in ruling out the presence of invasive cervical carcinoma. Therefore, the definitive treatment for cervical intraepithelial neoplasia (CIN)--hysterectomy in women who do not want more children--could be performed while the patient was still under the anesthetic used during procurement of the conization specimen. This technique reduces the risk of using anesthesia a second time and also reduces the costs of CIN treatment. Colposcopically directed conization should be done by experienced colposcopists only.

Adult↗

PubMed1983

The colposcopy clinic in a residency training program. Five years' experience with colposcopically directed biopsies followed by conization or hysterectomy.

Five hundred fifty-four patients with abnormal cytologic smears were screened in a special clinic by gynecology residents under faculty supervision using colposcopy and biopsies. Two hundred fifty patients who were evaluated by colposcopy subsequently had conization or hysterectomy. Colposcopically directed biopsies were accurate (comparable to the surgical specimen) in 92%. Three patients had invasive cancer high in the endocervical canal that was found by conization after endocervical curettage and colposcopy had indicated less-severe disease. Persistent or recurrent dysplasia was found in approximately 5% after conization and in none after hysterectomy. Because 23% of patients were lost to follow-up after treatment and an additional 19% had inadequate follow-up, management of CIN III with local destruction (cryocautery, electrocautery, laser) does not seem advisable.

Adolescent↗

PubMed1994

[Electro-conization of the uterine cervix in the Department of Oncologic Gynecology in Lodz in the years 1968-1987].

Considering the carcinoma incidence rate in women population the cervical carcinoma takes the second place. The diagnosis and proper treatment of the precancerous conditions and the preinvasive carcinoma cause the reduction of invasive cancer incidence rate. In this paper, it has been presented 20-years experience concerning cervical electro-conization in above mentioned department. The 1515 patients with the precancerous conditions and the carcinoma intraepitheliale were studied. The electro-conization has made possible the recovery in 98.0% patients. It has been found that the electro-conization is a very valuable diagnostic and therapeutic procedure, does'nt cause any serious complications and provide with undamaged samples for histopathological studies.

Adolescent↗

PubMed1994

Loop electrosurgical excision procedure for conization of the uterine cervix.

The application of loop electrosurgical excision procedure (LEEP), a new method of conization of the uterine cervix used to diagnose cervical intraepithelial neoplasia (CIN) or cervical cancer is presented herein. A loop electrode consists of a thin wire that allows deep excision of the transformation zone (TZ). The cone-shaped tissue removed can be examined histologically. Over a period of one year, a total of 41 cases underwent LEEP. Without anesthesia, the patients did not have any noticeable pain during the procedure. There were no complications, such as fever, wound infection, massive bleeding or cervical stenosis. In low-grade CIN, follow-up colposcopy and cytology did not show persistence or recurrence. In two cases of high-grade CIN, subsequent hysterectomy revealed residual lesions on hysterectomized specimens. LEEP is a simple and quick procedure of diagnostic conization that can be done at the first visit without major complication. If the histopathology after LEEP is moderate- to high-grade CIN or invasive cancer, the conization cannot be regarded as a sufficient therapeutic procedure, and such a patient needs further treatment.

Biopsy↗

PubMed1994

[Electro-conization with the diathermic loop. Indications and results].

The experiment of electro-conization with diathermic loop was effected on 185 patients. The indications are represented by: a) low grade lesions: 21 cases (11.3%) only when the squamo-columnar junction was into the endocervix; b) CIN 2: 44 cases (23.7%): c) CIN 3: 118 cases (63.7%); d) cyto-histologic discordance: 2 cases. After one year, the following results could be noted: 94.1% of the patients were cured, only 11 out of the 185 presented a recurrence (or persistence). It seemed interesting to us to study the factors which could influence the "in sano" (Free margin)/or not character of the resection. It appeared that the surface of the lesion did not seem to influence its histological result since we got: 83%, 96%, 94.5% and 92.3% of "in sano" conizations to be correlated with a lesion surface equal to 1/4, 2/4, 3/4, 4/4 of the cervical area. The second factor to be studied was the patients' age. So from 15 to 25 years (96%) of the resections were "in sano". There from 26 to 35 (92%), and from 36 to 45 (91.9%). Among post-menopausal women from 46 to 55 years old only 86.4% of electro-conizations were "in sano". Histologic alterations of the histologic specimen were noted in two cases (1%), the interpretation was easy and clear in the other cases. What about the complications? In 2 cases a moderate stenosis was to be noted; in 2 other cases: post-operative hemorragiae which were treated by a selective electro-coagulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗