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根据阴道镜印象,比较转化区环形切除术(C-LETZ)与冷刀锥切术(CKC)在高级别病变(HGL)中的成功率和并发症。

Comparison of success rate and complications of contour-loop excision of the transformation zone (C-LETZ) with cold knife conization (CKC) in high grade lesion (HGL) from colposcopic impression.

作者信息

Janthanaphan Manop, Wootipoom Virach, Tangsinmunkong Kobkul, Liabsuetrakul Tippawan

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkla, Thailand.

出版信息

J Med Assoc Thai. 2009 Dec;92(12):1573-9.

Abstract

OBJECTIVE

To compare the complications and success rate of Contour-Loop Excision of the Transformation Zone (C-LETZ) with Cold Knife Conization (CKC) in High Grade Lesion (HGL).

MATERIAL AND METHOD

Between April 1st, 2007 and November 30th, 2007, forty-five C-LETZs were performed in patients who had Pap smear result of High grade Squamous Intraepithelial Lesion (HSIL) or Squamous Cell Carcinoma (SCC) combined with colposcopic impression of satisfactory HGL by using the "See and Treat" approach. Success rate, tissue size, operating time, blood loss, intra-operative, and post-operative complications (2 weeks) were recorded to compare with the retrospective results from therapeutic CKC.

RESULTS

Forty-five cases of C-LETZ and 50 cases of CKC were compared. Using the "See and Treat" approach, the over-treatment rate was 6.7% (3/45). The success rate and tissue size were not different between both groups. The operating time, blood loss, and post-operative infection were significantly less in the C-LETZ group.

CONCLUSION

The authors compared CKC with C-LETZ, which is a new method for the management ofHGL of the cervix and found C-LETZ to be a favorable method with comparable efficacy but with significantly less morbidity, and suitable as a "See and Treat" method in a hospital outpatient clinic.

摘要

目的

比较宫颈转化区环形切除术(C-LETZ)与冷刀锥切术(CKC)治疗高级别病变(HGL)的并发症及成功率。

材料与方法

2007年4月1日至2007年11月30日,对45例巴氏涂片结果为高级别鳞状上皮内病变(HSIL)或鳞状细胞癌(SCC)且阴道镜检查印象为满意的HGL患者采用“即见即治”方法行C-LETZ手术。记录成功率、组织大小、手术时间、出血量、术中及术后并发症(2周),并与治疗性CKC的回顾性结果进行比较。

结果

比较了45例C-LETZ病例和50例CKC病例。采用“即见即治”方法,过度治疗率为6.7%(3/45)。两组的成功率和组织大小无差异。C-LETZ组的手术时间、出血量和术后感染明显较少。

结论

作者比较了CKC与C-LETZ(一种治疗宫颈HGL的新方法),发现C-LETZ是一种疗效相当但发病率明显较低的理想方法,适合作为医院门诊的“即见即治”方法。

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