Cervical HSIL patients at childbearing age:clinical efficacy and pregnancy outcome of CO2 laser ablation and LEEP
10.3969/j.issn.1672-8467.2024.05.005
- VernacularTitle:CO2激光与LEEP术治疗适龄期女性宫颈高级别鳞状上皮内病变的临床疗效及妊娠结局
- Author:
Qing LI
1
;
Hong-Wei ZHANG
;
Li-Mei CHEN
;
Qing CONG
;
Qing WANG
;
Long SUI
;
Ke-Qin HUA
Author Information
1. 复旦大学附属妇产科医院宫颈疾病诊疗中心 上海 200011
- Keywords:
CO2 laser vaporization;
loop electrosurgical excision procedure(LEEP);
cervix;
high-grade squamous intraepithelial lesion(HSIL);
pregnant outcome
- From:
Fudan University Journal of Medical Sciences
2024;51(5):677-683
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical efficacy and pregnancy outcomes of CO2 laser and loop electrosurgical excision procedure(LEEP)surgery in the treatment of cervical high-grade squamous intraepithelial lesion(HSIL)in women of childbearing age.Methods Patients with cervical HSIL of appropriate reproductive age(20-34 years old)who underwent satisfied colposcope,subsequently treated with laser or LEEP between Jan 2019 and Dec 2021 in Obstetrics and Gynecology Hospital,Fudan University were collected.All the patients were interpreted as transformation zone(TZ)type 1/2,and colposcopy biopsy diagnosed as cervical high-grade squamous intraepithelial lesion(HSIL)and received laser or LEEP according to the physician's advice and the patient's wishes.The effectiveness of the two surgeries was evaluated,and postoperative cytology,HPV result,and colposcopic pathology were compared.We monitored the surgical pregnancy rate,pregnancy complications,and pregnancy results after the surgery.Results A total of 566 cases,including 233 laser cases and 333 LEEP cases,were enrolled.There was no significant difference between the two groups in terms of preoperative cytology,HPV distribution,or the length of cervical canal.After 6 months of surgery,91.5%of patients who underwent laser therapy and 86.9%of those who underwent LEEP had normal cytology.The histology cure rate was 91.5%and the HPV conversion rate was 74.6%in both groups.The results of cytology,HPV,and colposcopic pathology had no significant difference between the two groups.The length of postoperative cervical canal was significantly longer in laser group than that in LEEP group[(29.09±3.15)mm vs.(27.05±3.84)mm,P<0.001].There was no statistically significant difference in postoperative pregnancy rate and pregnancy outcome between the two groups.Conclusion Laser ablation and LEEP produce comparable effects pregnancy outcomes in cervical HSIL patients with TZ types 1 and 2,while LEEP has pathologic feedback,so its misdiagnosis of invasive cancer reduce.
