This is achieved by the excision or ablation of the squamous-cylindrical area up to the healthy tissue. In the case of persistence of high-grade lesions after repeated excision and if the patient does not want to preserve fertility, hysterectomy may be indicated. This is a surgical procedure that can be indicated for benign gynaecological pathology, preinvasive cervical neoplasia and stage IA1 of cervical cancer.
Conization was the surgical choice in patients with cervical intraepithelial neoplasia, under 35 years of age, who wanted to conserve fertility and did not have other gynaecological lesions. Hysterectomy was the surgical treatment in patients over 35 years of age, with finished pregnancy planning and associated uterine pathology to intraepithelial cervical neoplasia.
Keywords management of cervical intraepithelial neoplasia, conservative treatment, radical treatment Rezumat Tratamentul neoplaziei intraepiteliale cervicale vizează eliminarea zonei de joncţiune, inclusiv a ţesuturilor anormale.
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Acest lucru se realizează prin excizia sau ablaţia zonei scuamo-cilindrice până la ţesutul sănătos. În cazul persistenţei leziunilor de grad înalt după excizie repetată şi în cazul în care pacienta nu doreşte să îşi prezerve fertilitatea, poate fi indicată histerectomia.
Aceasta este o procedură chirurgicală care poate fi indicată pentru patologia ginecologică benignă, neoplazia cervicală preinvazivă şi pentru stadiul IA1 al cancerulului de col uterin. Obiectivul studiului a fost selectarea cervical cancer young age în funcţie de managementul neoplaziei intraepiteliale cervicale, luând în considerare gradul leziunii cervicale, zona de extensie, vârsta pacientelor şi dorinţa de menţinere a fertilităţii, precum şi patologia asociată cu leziunile cervicale.
Conizaţia a fost procedura chirurgicală selectată la pacientele cu neoplazie cervical cancer young age cervicală, sub 35 de ani, care au dorit să-şi prezerve fertilitatea şi nu au avut alte leziuni ginecologice.
Histerectomia a fost tratamentul chirurgical la pacientele cu vârsta de peste 35 de cervical cancer young age, fără dorinţă de procreare şi patologie uterină asociată cu neoplazia cervicală intraepitelială. Cuvinte cheie managementul cervical cancer young age intraepiteliale cervicale tratament conservativ tratament radical Introduction The treatment of cervical intraepithelial neoplasia aims at removing the junction area, including abnormal tissues.
Ablation procedures — electrofulguration, cryosurgery, carbon dioxide laser — are an effective therapeutic way for non-invasive lesions, but they destroy tissues and cannot perform a proper histological assessment.
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It is absolutely necessary to exclude the possibility of neoplasia by cytological, colposcopic and histological examinations before applying ablative procedures. Excision is a surgical procedure that allows the complete histological evaluation of the piece, having both diagnostic and therapeutic character.
It is indicated for patients with suspected invasive cancer lesions and endocervical adenocarcinoma, high-grade lesion in cytology, unsatisfactory colposcopy and cervical intraepithelial neoplasia CIN diagnosed at the fragmentary biopsy, requiring treatment, and for patients with recurrent atypical glandular cell cytology AGC of recurrent high-grade CIN.
The patients with recurrent CIN have an increased risk for occult invasive cancer 1.
- Ovarian cancer genetic testing
- Cancer prostata speranta de viata
The excision procedures — with electric loop LEEP, conization — increase the risk of complications, affecting the reproductive capacity: cervical canal stenosis, cervico-ischemic incompetence, premature birth, premature rupture of membranes 2. The patients with an interval cervical cancer young age less than months between conization and pregnancy are at risk of premature birth 3.
According to some recent studies, the HPV infection may also increase the risk of cardiovascular diseases. Strains of HPV 16 and 18 are strains with a high cancer risk, known to cause almost all cases of cervical cancer while also increasing the risk to develop oropharyngeal cancer.
The cervical cancer young age with premature birth is uncertain, a number of studies cervical cancer young age an increase in risk, while other studies did not support this hypothesis On this basis, the treatment is preferred for the eradication of high-grade injuries. In the case of persistence of high-grade lesions after repeated excisions and if the patient does not want to preserve fertility, hysterectomy may be indicated.
Simple hysterectomy involves the removal of the uterus and cervix, but does not involve the excision of parameters and paracolpos.
Corelaţii clinice şi paraclinice în managementul neoplaziei intraepiteliale cervicale
It is a surgical procedure that can be indicated for benign gynaecological pathology, preinvasive cervical neoplasia and stage IA1 of cervical cervical cancer young age.
Adenocarcinoma in situ is diagnosed at younger ages The therapeutic objective is to excise all affected tissues after eliminating the diagnosis of invasiveness.
It is indicated the cold scalpel conization to keep the edges and to facilitate cervical cancer young age histological interpretation. Hysterectomy is indicated after the maternity is ended 12, Method The study was conducted on a total of 44 patients, between January and May The patients were aged between 21 and 50 years old, and they were divided into two groups: years old cervical cancer young age years old. Patients came in for routine gynaecological examination, persistent leucorrhoea or minimal vaginal bleeding after local washing or sexual intercourse.
The objective gynaecological examination revealed the shape and consistency of the cervix, the presence or absence of macroscopically visible exocervical lesions. Investigations such as cervico-vaginal cytology, HPV testing and genotyping, colposcopy and fragmentary biopsy or conization were performed to determine the extent of cervical lesions.
Detailed anamnesis, gynaecological clinical examination, biopsy curettage and ultrasound revealed in 17 patients uterine-associated lesions such as uterine fibromatosis and endometrial hyperplasia.
The histopathological diagnosis was based on tissue fragments obtained by biopsy or cervical conization and endouterine fractionated curettage. The treatment of cervical intraepithelial neoplasia was established according to the conditions, indications and contraindications, and consisted in conization or hysterectomy.
Table 1. Table 2.
The distribution of cervical cancer young age by the results of the cervical-vaginal cytology test Figure 1. Figures 2 and 3. Table 3. The treatment of these patients was total hysterectomy to achieve the excision of the cervical lesions and the uterine pathological body. Under these circumstances, cervical lesion has priority in setting the therapeutic decision, and not the age or the preservation of fertility.
These patients were predominantly under the age of 35 or wanted to maintain fertility, so they had conservative treatment. Table 4. The distribution of patients by the results of histopathological examinations Discussion The surgical treatment in patients younger than 35 years old who wanted to conserve fertility benefited from conization, both as a biopsy method and as cervical cancer young age treatment, although conization increases the risk of adverse effects on the reproductive function.
Post-surgical monitoring is required. Patients with CIN and negative resection margins are monitored by cytology examination once every 6 months until two consecutive negative results are obtained and then routinely supervised; one can test the presence of HPV DNA between 6 and 12 months after the treatment followed by colposcopy if HPV DNA is detected, because it is a marker of the persistence of the disease