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At least 235 records · Page 13Linked to original sources
PubMed1982

Does cervix conization increase the risk of complications in subsequent pregnancies?

In a series of 414 patients who underwent cervix conization because of cancer in situ, the risk of complications in subsequent pregnancies was analyzed by studying the outcome of their 923 pregnancies before and after cone biopsy. After conization the incidence of late spontaneous abortion was seven times higher than before. Moreover, 20.5% of pregnancies following cone biopsy required cervix cerclage because of suspected cervical insufficiency, or cesarean section because of a scarred cervix stenosis.

Abortion, Spontaneous↗
PubMed1986

Plasminogen activator and fibrinogen/fibrin degradation products at conization of the uterine cervix.

In women undergoing conization of the uterine cervix, peripheral blood samples and blood samples from the cone cavity were obtained and analysed for their concentration of plasminogen activator of tissue type (t-PA) and of urokinase type (u-PA) and the concentration of fibrinogen/fibrin degradation products (FDP). A significant increase was found for t-PA (p less than 0.002) and u-PA (p less than 0.0002) as well as for FDP (p less than 0.002) in blood from the cone cavity compared with peripheral blood. The finding of increased liberation of plasminogen activators strengthens the rationale for administration of synthetic inhibitors of fibrinolysis to reduce the frequency of bleeding complications at conization.

Antifibrinolytic Agents↗
PubMed1993

Outpatient CO2 laser excisional conization for cervical intraepithelial neoplasia under local anesthesia.

AIM AND OBJECTIVE: To evaluate the feasibility of CO2 laser excisional conization in patients with cervical intraepithelial neoplasia (CIN) in an outpatient setting under local anesthesia. DESIGN: A prospective study of women with cervical intraepithelial neoplasia over one year recording early and late complications, cure rate, and patients' compliance. The procedure was performed with a Coherent CO2 laser connected to the colposcope with a micromanipulator. The equipment attaining 19,700 W/cm2, spot diameter 0.43 mm, focus distance 300 mm, and continuous beam. RESULTS: The material included 81 women. Seventy-eight women were treated as outpatients, while three women were admitted for 24 hours observation due to surgical and technical complications during the treatment. Sixty-six percent of the women had bleeding less than 10 ml during the treatment. One woman was admitted 24 hours after surgery due to bleeding requiring suturing. Median operation-time was 11 minutes (range 3-60). All specimens contained CIN. In 76% of the cases the pre- and postoperative diagnosis were identical. Twelve specimens had CIN in one or both margins. Abnormal cytology after conization was found in three cases (4.2%). High patient compliance was found as 92% of the treated women would choose the same kind of treatment if it had to be repeated. CONCLUSION: High success rate, few complications and high patient compliance make the procedure adequate as a routine procedure in treatment and diagnosis of CIN.

Adult↗
PubMed1994

Does the loop electrosurgical excision procedure adversely affect the histopathological interpretation of cervical conization specimens?

OBJECTIVE: To assess the suitability of conized specimens obtained by loop electrosurgical excision procedure for histopathological interpretation. METHODS: We evaluated the histological pictures of 215 tissue sections obtained by loop electrosurgical excision procedure. These sections came from 32 cases of patients with various degrees of cervical intraepithelial neoplasia. All women included in our study had a satisfactory colposcopy and no cytological or colposcopic evidence of invasive cancer. We quantified the thickness of thermal damage in the tissue sections using a stage-mounted, calibrated grid microscope. RESULTS: At its greatest extent, thermal damage occurring next to incision lines ranged from 160 to 520 mu (mean 262, SE 14 mu). Two different zones of thermal damage were produced by LEEP: the carbonization and coagulation zones. The carbonization zone was located at the outermost layer and was very thin, measuring from 10 to 30 mu in depth. The coagulation zone was adjacent to the carbonization zone, was eosinophilic, and was significantly deeper than the carbonization zone at its points of greatest thickness (150 to 500 mu; p < 0.0001, Student's t-test). The depth of the coagulation zone correlated significantly with the depth of the carbonization zone (p = 0.041, least linear correlation). Tissue distortion was present in 53% (17/32) of the cases, and appeared only in the coagulation zone. CONCLUSION: Tissue structure from the diseased portions of the conized specimens was generally well preserved. The area of thermal damage was limited and thus did not result in diagnostic problems. We conclude that LEEP is a reliable method for obtaining tissue samples for histopathological examination.

Adult↗
PubMed1975

Conization as treatment of carcinoma in situ of the uterine cervix.

A series of 343 consecutive cases with the preoperative diagnosis of carcinoma in situ of the uterine cervix treated by cervical conization is presented. In 93% of these patients cervical cytology returned to normal. The follow-up period ranged from 1 to 5 years. There was significantly greater chance for an apparent cure in cases in which histologic evaluation indicated free margins of resection (98%) than in those where the margins were involved by the neoplastic process (70%). Colposcopic evaluation to determine the site for punch biopsies and adequate resection margins could greatly enhance the success of therapeutic conization. The urgent need for conservative management of cervical intraepithelial neoplasia because of its predominance among young women is discussed.

Adult↗
PubMed1976

Comparison of colposcopy directed biopsies and cold knife conization in patients with abnormal cytology.

One hundred patients with abnormal cytology were evaluated by colposcopy, and histologic material was obtained by directed biopsies, cold knife conization and endocervical curettage. The colposcopy directed biopsies provided the diagnosis in 94 per cent of the patients, and the colposcopic impression was accurate in 89 per cent of the patients. Cold knife conization was performed in 98 patients, since two patients had invasive carcinoma on colposcopic directed biopsy. In 75 patients, the histopathologic finding on cone biopsy was in complete agreement with the directed biopsies. In 11 patients, the directed biopsies were a degree higher than on cone biopsy, and in six patients the histopathologic findings were a degree lower. In six patients the colposcopic directed biopsies missed the diagnosis of dysplasia. No patients with carcinoma in situ or invasive carcinoma were missed by the colposcopic directed biopsies.

Biopsy↗
PubMed1992

[Comparison of YAG and CO2 laser excisional conization for the treatment of uterine cervical neoplasia].

Thirty-nine patients with cervical neoplasia who were treated by CO2 laser excisional conization were compared with a group of 37 patients whose diagnosis and age were similar were treated by YAG laser excisional conization. Every operation in our series was performed on an outpatient basis. The differences between two groups were statistically significant: The CO2 laser group revealed the advantages in the healing periods from treatment to the end of epithelization (p less than 0.01: T test) and irradiation time (p less than 0.001). There was no difference in the blood loss during the operation. Both initial cure rates were 100% during the follow-up period of 21 to 65 months. During and post operations, more patients required additional measures such as sutures for uncontrollable bleeding in the CO2 laser group. In conclusion, both methods are felt to be good diagnostic and also therapeutic procedures for cervical neoplasia on an outpatient basis.

Female↗
PubMed1992

Inflammatory cell infiltrate in the cervix as a predictor of residual cervical intraepithelial neoplasia after conization.

From January 1985 to January 1991, 112 patients underwent conization of the cervix for dysplasia. Twenty-one had incomplete resection, with cervical intraepithelial neoplasia (CIN) extending to the endocervical margins of resection. Only 10 had persistent CIN in follow-up. A decrease in the inflammatory cell infiltrate in the cervical stroma of the conization specimen was associated with persistent disease. A simple technique for quantitating this inflammatory cell infiltrate was used. Smoking was associated with a suppression of this local immune response in the cervix.

Adult↗
PubMed1991

Cervical intraepithelial neoplasia extending to the margins of resection in conization of the cervix.

Conization of the cervix is still widely utilized under certain conditions for the diagnosis and treatment of cervical intraepithelial neoplasia (CIN). Little has been written about the management of disease extending to the margins of resection. Ninety-four patients underwent conization of the cervix for cervical intraepithelial neoplasia (CIN). Nineteen (20%) had positive margins of resection; 10 (56%) of them had no evidence of disease in follow-up of one to four years. The inflammatory response of healing may play a role in a cure. Positive margins of resection and persistent disease, noted in 44%, were positively associated with higher grades of CIN and smoking. Smoking was also a risk factor for recurrent disease in those with negative margins of resection.

Adolescent↗
PubMed1991

[A method for the repair of the cervix uteri in conization].

The technique for repair of the uterine cervix after circumferential cut and conization is described. The sewing is made by placing two symmetrical sutures, by which invagination is achieved simultaneously at sagittal and lateral sides. The authors have used the method in 400 patients for a period of 12 years as its good hemostatic and plastic effect is established. Attention is also paid to the observation on 18 women, who have became pregnant and delivered after conization and repair of the uterine cervix by the described method--11 out of 18 women have been delivered of infants through natural birth pathways.

Cervix Uteri↗
PubMed1989

Cervical intraepithelial neoplasia with conization: early complications and follow-up.

The authors made a review of the last 100 cases who underwent a conization of the cervix during the period 1980-1986. Cyto-histological evaluation was compatible in 78% of the cases with a cervical intraepithelial neoplasia of third degree and in 22% with a CIN of first and second degree. Early post-operative complications consisted of a hemorrhage in 3% of the cases, easily stopped with a vaginal packing. In 2% of the cases a risuture under general anaesthesia was required. In 1 case the stitches loosened and in another a urinary infection was present. Twenty-six patients underwent total hysterectomy after conization for different indications; only one patient had a relapse after six months as there was a moderate dysplasia localized in the vaginal vault. During the follow-up, 14 patient became pregnant. Among these, 5 underwent legal termination during the first trimester and 9 delivered at term without any complication. During these follow-up of 7 years in the older cases and 6 months in the more recent ones, 6 cases displayed a persistence of the disease after 3 months, (CIN of variable degree) and 2 cases relapsed at the second colpocytological control. These patients, according to the age and the presence of clinical indications, underwent total hysterectomy or diathermic coagulation with resolution of the disease. A relapsing invasive tumor was never observed.)

Adult↗
PubMed1987

[Laser vaporization and incisional conization in cervical neoplasia as a conservative therapy].

We performed laser therapy for cervical neoplasia as a conservative therapy. Our materials were 202 cases (dysplasia-166, carcinoma in situ-36) treated by laser vaporization and 31 cases (dysplasia-7, CIS-7, questionable microinvasive cancer-17) by laser incisional conization. In addition to CO2 laser, we developed YAG laser and YAG/CO2 coaxial simultaneous laser for laser vaporization. On the other hand, we applied YAG laser for incisional conization with an attached laser rod (made of new ceramics) for use on an outpatient basis without anesthesia. Total cure rate after first treatment with laser vaporization was 93.0% (dysplasia 93.3%, CIS-91.7%). Pathological examination of the cone specimen revealed 8 cases of invasion (Ia stage-7, Ib stage-1). No abnormal findings could be found in follow-up cases. Complications were minimal in all cases. We thus demonstrated that simple and individualized management was possible for cervical neoplasia by applying either of these new methods.

Adult↗
PubMed1986

Frozen section evaluation of cervical conization specimens.

Frozen section evaluation was done on 96 conization specimens. One patient had invasive carcinoma, which was correctly diagnosed on frozen section. No patient received inappropriate therapy on the basis of an erroneous diagnosis made from the evaluation of frozen sections. The mean time from initiation of surgery to the surgeon's receipt of the frozen section diagnosis was 0.9 hours. There was no significant increase in the blood loss or intraoperative complication rate when frozen conization was added to either abdominal or vaginal hysterectomy.

Biopsy↗
PubMed1979

Microsurgical conization of the cervix by carbon dioxide laser.

The carbon dioxide (CO2) laser has been used to treat cervical intraepithelial neoplasis (CIN) by vaporization of colposcopically visible lesions. Recently, several investigators have reported a series of laser-treated CIN with very promising cure rates. The use of the laser to excise cervical tissue surgically has been neglected. A series of patients who have undergone cervical cone biopsies taken by the CO2 laser is presented. The tissue sections obtained from these cone biopsies are suitable for pathologic interpretation and study. The complication rate for cervical conization by laser is very low. Other advantages of this method of cervical conization are discussed.

Biopsy↗
PubMed1977

[Conization of the portio by Kullander's method].

The author presents his experience goined in performing 100 conizations after the modified Scott-Burghardt bloodless method reported by Kullander. In this whole series only one case of more serious postoperative bleeding (solved by electrocagulation) was recorded. Time advantages of the method over the previously used Sturmdorf method of conization with the plastic surgery of the portion are emphasized.

Adult↗
PubMed1984

Outpatient cervical conization.

One hundred outpatient cervical conizations were performed over a 2.5-year period. A circumferential suturing technique was used which provided excellent hemostasis and restoration of normal cervical anatomy. The complication rate was low. One patient had significant intraoperative hemorrhage, one experienced postoperative bleeding within 24 hours, and two had delayed bleeding. Three patients developed infection, and one patient was found to have asymptomatic cervical stenosis on follow-up examination. No patient required blood transfusion or admission to the hospital. It is concluded that cervical conization can be performed on an outpatient basis in the nonpregnant patient with an acceptable rate of complications.

Adolescent↗
PubMedDate not supplied

[Cervical pregnancy treated by conization].

Cervical pregnancy in a 23-year-old patients is presented. The local finding corresponded to criteria for the diagnosis of cervical pregnancy. The diagnosis was confirmed by an immunological test (Gonavislide) and ultrasound. Conization was applied, and in the conization material the pathologist found chorial villi with a great many trophoblasts in direct contact with the muscular cervical layer.

Adult↗
PubMed1980

Prediction of clearance of cervical intraepithelial neoplasia by conization.

In this review of 531 cervical conizations and 268 hysterectomies, the presence or absence of cervical intraepithelial neoplasia (CIN) at the margins of the cervical conization failed to predict the presence or absence of residual neoplasia in the excised uterus (P greater than .10). Older patients and patients with CIN III Papanicolaou smears had a significantly greater chance of having noncleared cone margins (P less .0005); no other criteria predictive of non-clearance emerged in this study. Two of 26 patients with CIN III at the cone apex or in the apical biopsies had residual stage IA neoplasia in the excised uterus. Conversely, when the cone predicted clearance, CIN III was the worst residual diagnosis.

Adult↗