Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Conization”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 847 records · Page 47Linked to original sources
PubMed1987

[Microinvasive stage Ia cancer of the uterine cervix--a population based analysis].

In a population based study, 782 cases of microinvasive cervical cancer stage Ia recorded in Berlin, capital of the GDR, between 1970 and 1978 were analyzed. As the consequence of a cytological screening programme started in 1973, the percentage of stage Ia-cancer increased to 30% in 1978 and 35% in 1984. The percentage of asymptomatic cases (86%) only detectable by colposcopy and/or cytology (92%) increased also considerably. The percentage of cases histologically confirmed by cone biopsy increased from 55% to 81%. During the period analyzed, the percentage of radically treated cases (Wertheim, Schauta, combined surgery and radiotherapy) decreased to 31%. Among 459 patients only treated by conization or simple hysterectomy 7 developed recurrences and 2 died from the disease despite of an intensive second treatment. Among 323 patients treated more radically (Wertheim, Schauta, combined surgery and radiotherapy), there was no recurrence but 5 deaths by early or late treatment complications. Therefore, observed cumulative survival rates of patients treated by conization or hysterectomy were slightly higher than those of patients treated more radically.

Adult↗
PubMed1986

[Epidemiology and early recognition of cervical cancer].

Probably due to intensive methods of early recognition, the incidence of uterine cervix cancer is decreasing in all industrialized countries. The efficiency of early recognition programs is well documented in literature, but these results are by far not achieved in clinical practice: for example only 30% of all women of childbearing age are reached by prophylactic medicine. There are also problems with respect to the quality assurance in cytology and colposcopy. As to etiology, certain papilloma viruses (HPV 16 and 18) are today a preferential object of research, but an individual risk has not yet been described exactly. This, however, would be important for the individualization of diagnostic methods, above all if they involve invasive procedures (e.g. Schiller abrasio, conization). This is also true for the treatment of early forms of uterine cervix cancer. The treatment, standardized to a large extent in former times (great surgical intervention according to Wertheim-Meigs in all cases) has now been replaced by an individualized therapy with a possibility to choose between conization, laser treatment if necessary, simple hysterectomy, and radical operation.

Combined Modality Therapy↗
PubMed1987

Positive endocervical curettage in patients with satisfactory and unsatisfactory colposcopy: clinical implications.

We studied a total of 177 patients with cervical intraepithelial neoplasia or invasive carcinoma to evaluate the clinical implications of a positive endocervical curettage. All patients underwent cervical conization. One hundred and ten women had unsatisfactory colposcopy; 67 had satisfactory colposcopy. Patients with unsatisfactory colposcopy had a higher frequency of invasive lesions in the endocervix (9 versus 1.5%, P less than .05) and involvement of internal cone margins (12 versus 0%, P less than .01); they were also more likely to require additional, frequent treatment for persistent or recurrent disease (9 versus 1%, P less than .05) than patients with satisfactory colposcopy. Histologic review of the cone specimens in patients with satisfactory colposcopy revealed no lesion deeper in the endocervical canal than was predicted by colposcopic examination. These observations suggest that selected patients with positive endocervical curettage may be managed without diagnostic conization, if they had a satisfactory colposcopic examination.

Biopsy↗
PubMed1978

A new topical hemostatic agent in gynecologic surgery.

Experiences with a topical hemostatic agent, microfibrillar collagen (MFC), material made from beef hide dermis are recounted. Topical hemostasis is facilitated by virtue of its fibrillar structure forming a sticky matrix for platelet aggregation. The material was used in women undergoing cervical conization to determine its absorption at hysterectomy 6 weeks later. In another group, it was used as the sole hemostatic agent at conization and compared with a control group in which conventional sutures were used. A larger group who underwent abdominal hysterectomy allowed comparison between MFC on the bladder muscularis and conventional suture ligature in terms of blood loss, operating time success of method used, and complications.

Administration, Topical↗
PubMed1984

[The evaluation of uterine endocervical lesions by cervicoscopy of lateral view type (clinical advantages for reduction of traditional surgical management of uterine cervical cancer)].

In this study an attempt was made to examine uterine endocervix by contact pan-endomicroscopy of the lateral view type (we call it cervicoscopy). Its clinical advantages are also investigated. 127 cases of uterine cervical neoplasms (including CIN) were examined to detect whether or not neoplastic foci existed in the cervical canal. It was found that vascular morphological configurations could be clearly observed. These findings are classified into several categories according to their morphological characteristics. It was found that there are many green asparagus-like vessels and/or root-like vessels in invasive foci but few in CIN foci. 56% of CIN foci, and 90% of advanced foci of endocervix were accurately diagnosed from the abnormal vascular findings. On the basis of what is described above, we examined the endocervical lesions from 40 conization candidates. 19 cases (48%) of the candidates were omitted because of negative advanced findings which were confirmed histopathologically afterwards. It suggested that a reduction in the number of conization candidates will be made possible with this new clinical examination.

Cervix Uteri↗
PubMed1984

Use of colposcopically directed, four-quadrant cervical biopsy by the colposcopy trainee.

Colposcopically directed cervical biopsies performed by experienced colposcopists have greatly reduced the need for conization of the cervix to evaluate patients with cervical intraepithelial neoplasia (CIN). Because of the subjectivity of the colposcopic technique and variable time required to become skilled, continued reliance on cervical conization is often recommended to validate colposcopic findings for novice colposcopists . We assessed the colposcopic skill of residents in training in obstetrics and gynecology who had received 9-12 months of instruction in colposcopic techniques. Biopsies of each quadrant of the ectocervix were done after the resident recorded his or her colposcopic diagnosis. In 26% of the patients there was overestimation or underestimation of the histologic findings by more than one grade in the cervical quadrant suspected on colposcopy to contain the most advanced CIN lesion. In 30% of patients the histologically most advanced CIN lesion was not identified by the colposcopist . In 11% of patients with histologic findings of CIN both cytology and colposcopy were negative. Only 69% of the histologically confirmed lesions were diagnosed colposcopically by the resident colposcopists . The four-quadrant, colposcopically directed biospy technique is recommended as an effective training method for the beginning colposcopist .

Adolescent↗
PubMed1978

Treatment of premalignant lesions of the uterine cervix by means of moderate heat thermosurgery using the SEMM coagulator.

71 patients suffering from premalignant lesions of the uterine cervix and who were treated by the SEMM coagulator, is presented. The results are good, and at least equal to cryosurgery. The time of follow-up has been more than 2 years for 57 of the patients and more than 3 years for 39. Only in two cases has there been persistence or recurrence of suspicious cytology requiring new treatment, in one of them by conization and in the other by cryosurgery. One patient was hysterectomized for other reasons 2 years post-treatment, but no sign of persisting malignant or premalignant changes were found in the specimen. The method is judged to be a valuable alternative to conization and cryosurgery.

Adult↗
PubMed1982

Contact hysteroscopic evaluation of the endocervix as an adjunct to colposcopy.

A total of 66 women with cervical intraepithelial neoplasia extending into the endocervical canal were investigated by endocervical curettage, contact endoscopy, and conization biopsy of the cervix. Although atypical epithelium was obtained in only 8 women by blind endocervical curettage, contact endoscopy identified 42 instances of disease of equal or greater magnitude than determined by the original ectocervical colposcopic evaluation. These findings were subsequently confirmed by conization biopsy. As the 6-mm contact hysteroscope may easily be inserted into the pregnant cervix, sufficient reassurance may be gained to avoid endocervical curettage or cone biopsy and thus to avoid the hazard of major hemorrhage and/or pregnancy interruption.

Biopsy↗
PubMedDate not supplied

[Cervical factor in sterile couples with an ovulatory cycle normospermia and patent tubes].

In 54 sterile married couples with a normal biophasic cycle, passable tubes, and normozoospermia, the properties of the cervical mucus were investigated. The biphasic cycle was determined according to the basal temperature curve, in which the hyperthermal phase lasts 12 days or more, the concentration of pregnanediol in the urine on the 22nd day of the cycle (6.4 mg/24h), estrogen on the 12th day of the cycle (78.4 micrograms/24h), and the LH concentration on the 13th day of the cycle (58.3 U/l). A positive crystallization test was found in 12 out of 54 patients and the postcoital test in 8 out of 54 patients. In 31 patients with the clinical symptoms of colpitis and cervicitis the culture of the cervical secretion showed pathogenic bacteria in 24 patients. Eighteen patients were subjected to conization previously. A positive crystallization test and a normal postcoital test were found only in 14 out of 17 patients following conization but in not single patient with cervicitis. After antibiotic therapy and stimulation with estrogens a restitution of the function of the cervical mucosa was observed in 25 patients, while 12 patients became pregnant. Inflammation proved to impair the normal function of the cervical mucosa, and if lasting long, it can lead to irreversible changes. Also surgery in cervix can result in the destruction and reduction of cervical glands and should therefore be strictly medically indicated and carefully performed, especially in nulligravidae.

Cervix Mucus↗
PubMed1995

[Endocervical adenocarcinoma in situ. A histological entity to know].

We report diagnosis and treatment problems encountered in 4 cases of adenocarcinoma in situ (AIS) of the uterine cervix. The patients' ages ranged from 24 to 45 years. In 2 cases, Pap smears revealed strips of cells showing crowded nuclei and pseudostratification of AIS. In 3 cases, the diagnosis of AIS was confirmed from a colposcopically directed biopsy and, in the last case, from a surgical cone biopsy. In 3 cases, AIS was found to be associated with cervical squamous intraepithelial neoplasia. In all cases, it was difficult to rule out an early invasive adenocarcinoma. Three patients underwent total abdominal hysterectomy. The topographic data of lesions, notably the presence of endocervical AIS in hysterectomy specimen realised 4 years after conization, and a review of literature lead us to propose hysterectomy as a basic treatment. If conization is chosen, it should be cylindrical with adequate diameter and height.

Adenocarcinoma↗
PubMed1995

[Diathermic loop treatment of subclinical cervical infection by human papilloma virus (HPV). Short-term effectiveness].

Multiple modalities of treatment have been employed since cervical subclinical papillomavirus (SPI) were discovered, with various degrees of success. The objective of this report is to assess the efficacy of the removal of cervical SPI by mean of LEEP in office conization. During the period from January 1992 and December 1993, 49 patients with histologically proven HPV infection were treated at the Private Colposcopic Clinic with LEEP. Patients ages ranged from 20 to 49 years old with average 36.1 years, mostly were parous woman. Satisfactory specimens suitable for histologic examination was obtained and in all cases margins of excisions appeared histologically clear of HPV infections patients discomfort was none or minimal in 45 patients (91.8%) and moderate in 4 (8.1%). There were 5 cases (10.2%) of postoperative haemorrhage and 3 cases (6.1%) of minimal cervical infections. The mean base of cone biopsy was 1.43 cm, and ranged from 1.0 to 3.0 cm. The overall cure rate of LEEP was 98% because there was only one confirmed case of treatment failures by loop conization. We concluded that this term results are satisfactory.

Adult↗
PubMed1995

[Micro-invasive cancer of the uterine cervix].

There is no current international consensus on the classification of microcarcinomas. There is still controversy over the depth of the stroma invasion and lymph node invasion as well as on confluence of invasive spread. The FIGO classification has been used since 1985 in which microinvasive carcinomas are considered as infraclinical cancers forming a group classed as stage 1a and divided into subgroups: 1a1 = early invasion of the stroma < 1 mm in depth; 1a2 = microinvasive carcinoma with invasion < 5 mm and width < 7 mm. Two important practical points must be added to this classification: demonstration of emboli via lymphatic or blood stream dissemination. Microinvasive carcinoma is demonstrated on conization specimens obtained after guided biopsy revealed intraepithelial neoplasia. Treatment can be standardized on the basis of the pathology report on the conization specimen.

Female↗
PubMed1994

Cervical intraepithelial neoplasia (CIN): management by a general (non-oncological) gynaecological unit.

The purpose of this study is to assess how well Cervical Intraephithelial Neoplasia (CIN) was managed by a general gynaecological unit. Treatment consisted of laser ablation, conization (laser, knife, loop diathermy) and hysterectomy. Recurrence occurred in 8 (18.2%) out of 44 conizations and 2 (25.0%) out of 8 ablative procedures. While the cure rate after the first treatment was 81.1%, after subsequent treatment it became 96.2%. This study showed that it was possible for a general gynaecological unit to cure patients of their disease. The Pap smear tests were not very accurate--the sensitivity and specificity were 75.5% and 50.0% respectively while the positive predictive value and negative predictive value were 94.9% and 14.3% respectively. Similarly, colposcopically directed punch biopsy was also found to be misleading.

Adolescent↗
PubMed1994

[Microinvasive cervico-uterine cancer. Diagnosis and treatment].

This is a retrospective review of 63 patients with diagnosis of microinvasive cervical carcinoma. Diagnostic methodology included etiology, colposcopy, biopsy and cervical conization. Study parameters were: age, symptomatology, type of treatment and survival. The treatment to be established was chosen according to adverse prognostic factors, such as invasion depth, lymphovascular permeation, invasion pattern. The patients with an invasion depth up to 1 mm (IA1, FIGO) may be conservatively treated by cervical conization, if fertility is to be kept; there is risk of metastasis or recurrence. The patients with invasion of 1 to 5 mm (IA2, FIGO) may have a greater risk of recurrence and lymph node disease; the treatment should be individualized. There are no specific colposcopic data about microcarcinoma, and because of that, diagnostic precision is not high; however, colposcopy shows the adequate site for biopsy sampling, identifies vaginal extension areas and may influence the treatment.

Adult↗
PubMed1994

[Current conservative surgery in cervical intraepithelial neoplasia].

5 years (1989-1993) experience of cervical conization including 57 cases, has been reviewed. The mean follow-up was 33 (6-60) months. Mean age was 34.6 (range 21-57) years. Mean height and diameter of the cones were 2.5 +/- 0.3 cm and 1.5 +/- 0.4 cm, respectively. In 55 cases there were free margins of the cones. Cytological diagnosis was CIN I for 8 patients, CIN II for 21 patients, CIN III for 22 patients, CIN+HPV for 6 patients. In 40 of the 57 patients suspected of having a cervical intraepithelial neoplasia on cytology and on colposcopy, the histology was confirmative. Bleeding (the most common pre and postoperative complication) was observed in 6 cases (11.7%). In three patients a new conization was necessary and in the other two patients hysterectomy was necessary. No significant differences were noted in the pregnancy outcome following either treatment in five patients.

Adult↗
PubMed1994

Cervical intraepithelial neoplasia: current management options.

Cervical intraepithelial neoplasia is an increasingly common finding among sexually active young women. Many of these women have not completed their families, so preservation of fertility is an important factor to consider when planning appropriate treatment. In the past, management of precancerous cervical lesions was aggressive, primarily consisting of conization of the cervix. This procedure yielded excellent cure rates but was associated with a high incidence of complications. The widely accepted use of colposcopy in the evaluation of abnormal cervical cytology and the use of ablative and conservative excisional treatment modalities have resulted in a decreased number of conization procedures. More recently, management of cervical intraepithelial neoplasia has taken a more conservative approach. This article describes the risks and benefits of the multiple modalities available for the management of cervical intraepithelial neoplasia.

Cryotherapy↗
PubMed1994

[A clinical study on the complications associated with laser therapy for cervical neoplasia].

Six hundred and fifty-nine patients with cervical neoplasia were treated by either vaporization (395 patients) or excisional conization (264 patients) with various Lasers. The complications associated with the therapies were examined with reference to the Laser sources and in the local anesthesia and non anesthesia groups. Six hundred and thirty-nine patients were treated on an outpatient basis without local anesthesia (37.7%) or with local anesthesia (62.3%). During the procedures, the patients complained of pain and a hot sensation in the lower abdomen in 64.6% in the vaporization (vapor) group and 60.7% in the conization (cone) group. In the local anesthesia group, 2.9% of the vapor and 4.0% of cone group complained of nothing. Uncontrollable bleeding during the procedures was most common in 12.8% and 32.3% in the CO2 vapor and cone groups, respectively. Misirradiation of the vaginal wall and vulva occurred in 3.3% in all vapor groups. On the other hand, the incidence of burns to both areas in all cone groups was 7.2%. The patients who were given an analgesic were 1.3% in all vapor groups and 2.5% in all cone groups. Delayed bleeding in those who received some treatment to stop it occurred in 14.7% in all vapor groups and also in 11.0% in all cone groups. Cervical stenosis was seen in 3.8% in all vapor groups and in 8.6% in all cone groups. No infection of the lasered site was observed in the vapor groups, but was observed in 0.8% in the cone groups. The culture test showed both E. coli positive.

Abdominal Pain↗
PubMed1977

The significance of age in the colposcopic evaluation of women with atypical apanicolaou smears.

As women age, atypical Papanicolaou smears are associated with more advanced cervical neoplasia. The woman under age 30 had less than one chance in a hundred of having invasive carcinoma if she has an atypical Papanicolaou smear, while the woman over age 60 has one chance in six of this finding. An atypical Papanicolaou smear does not necessarily mean neoplasia is present; 23% of the women evaluated for atypical smears had a negative evaluation, and this included women over age 60. Endocervical currettings containing neoplastic tissue frequently are seen after age 30 and may contribute significant information to the final diagnosis; stenosis of the endocervix, however, may prevent curettage in postmenopausal women. Diagnostic conizations of the cervix rarely are necessary prior to age 30 if colposcopic technics are used. The need for conizations increases by decade of age and is required in at least one-third of postmenopausal women evaluated initially by colposcopy.

Adolescent↗