Clinical evaluation of cervicectomy in the treatment of cervical intraepithelial neoplasia with cervicovaginal shortening
- Author:
Yue QI
1
;
Qiu-lin YE
1
;
Miao LIU
;
Pei-yao WANG
1
;
Hui-min WANG
;
Juan-juan LIU
1
;
Lian-cheng ZHU
1
;
Bing-ying LIU
1
;
Dan-ye ZHANG
1
;
Bei LIN
1
Author Information
- Publication Type:Journal Article
- Keywords: cervical intraepithelial neoplasia; cervicovaginal shortening; cervicectomy; HPV
- From: Chinese Journal of Practical Gynecology and Obstetrics 2019;35(10):1130-1136
- CountryChina
- Language:Chinese
- Abstract: OBJECTIVE: To investigate the clinical efficacy of cervicectomy for cervical intraepithelial neoplasia(CIN)in patients with cervicovaginal shortening.METHODS: Retrospectively analyze the clinical data of the 120 cases of CIN treated in Shengjing Hospital of China Medical University from April 2014 to November 2018.Cervicectomy was performed because of cervicovaginal shortening caused by menopausal or peri-menopausal cervical atrophy or cervical surgery.The clinical treatment,efficacy and prognosis of the patients were reviewed.RESULTS: The mean age of the 120 patients was 55.2 years(range:35-77 years).The indications of operation included:persistent abnormal cervical cytology test(7),CIN2(42),CIN3(70),squamous carcinoma of the cervix(1);peri-menopausal and menopausal patients with obvious cervicovaginal atrophy(100),premenopausal patients with natural short cervix(2),and obvious cervicovaginal shortening caused by cervical surgery(18).The mean operating time was 23.2 min(range 10-30 min),the mean bleeding volume was 7.8 mL(range:5-20 mL),and the mean height of cervix resected was 2.59 cm(range:2-3 cm).No secondary injury,bleeding or other postoperative complications occurred during surgery;cervical postoperative wounds healed well;only one case developed cervical adhesion after surgery.The postoperative histologic diagnosis were compared with the preoperative histologic diagnosis,in which 45 degraded(37.50%),42 consistent(35.00%),and 33 upgraded(27.50%).HPV conversion rate 3 months after cervicectomy was 80.81%(80/99),and total HPV conversion rate was 88.89%(88/99).A total of 29 patients underwent secondary surgery,23 underwent total hysterectomy,and 6 underwent extensive hysterectomy and pelvic lymphadenectomy.All patients were followed up,once every 3 to 6 months,and median follow-up time was 29.5 months(range 4-59 months).All patients recovered well after surgery;only 2 cases showed positive margins,and only 2 cases of residual disease and 1 case of recurrence were found during follow-up.CONCLUSION: For patients with cervical intraepithelial neoplasia of cervicovaginal shortening,cervicectomy is a safe,effective and relatively microinvasive treatment.
