Gynecological Oncology Unit - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy.
Gynecologic Section, Department of Odontostomatological and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy.
Medicine (Baltimore). 2022 Jul 22;101(29):e29586. doi: 10.1097/MD.0000000000029586.
To analyze the histopathological findings in postmenopausal women who underwent hysterectomy for postsurgical cervical stenosis, evaluating the incidental findings of preinvasive or invasive uterine and cervical disease.
Retrospective case series of postmenopausal women who underwent hysterectomy for postsurgical cervical stenosis at Gynecological Oncology Unit of Istituto di Ricovero e Cura a Carattere Scientifico Centro di Riferimento Oncologico Aviano-National Cancer Institute from January 2014 to January 2021.
During the study period, 36 women underwent hysterectomy for postsurgical cervical stenosis at our institution. Cervical stenosis occurred 10.2 ± 5.6 years from the onset of menopause. In particular, 26 (72.2%) patients underwent a single loop electrosurgical excision procedure or carbon dioxide (CO2)-laser conization before the onset of stenosis. The remaining 10 (27.8%) women had multiple surgical excision before the onset of stenosis. At the final histopathological analysis, 17 (47.2%) patients had a preinvasive or invasive gynecological disease. In particular, 9 cases of cervical disease (including 1 case of endocervical squamous cell carcinoma pT1a) and 6 cases of endometrial hyperplasia emerged. Also, 2 cases of tubo-ovarian diseases were found.
Postsurgical cervical stenosis is a challenging clinical condition, especially in women treated for cervical intraepithelial neoplasia or microinvasive cervical cancer. As shown, cervical stenosis can prevent an adequate gynecological follow-up and a prompt diagnosis of malignancies. Therefore, postmenopausal women with cervical stenosis should be carefully counseled, and hysterectomy could be a reasonable option, especially in those cases in which a conservative approach is not feasible, failed, or is not accepted by the patient.
分析因术后宫颈狭窄行子宫切除术的绝经后妇女的组织病理学发现，评估子宫和宫颈潜在浸润性或浸润性疾病的偶然发现。
回顾性分析 2014 年 1 月至 2021 年 1 月在妇科肿瘤科接受因术后宫颈狭窄行子宫切除术的绝经后妇女的病例系列。
研究期间，我院有 36 名妇女因术后宫颈狭窄行子宫切除术。宫颈狭窄发生在绝经后 10.2±5.6 年。具体而言，26 例（72.2%）患者在狭窄发生前接受了单次环形电切除术或二氧化碳（CO2）激光锥切术。其余 10 例（27.8%）患者在狭窄发生前接受了多次手术切除。在最终的组织病理学分析中，17 例（47.2%）患者患有潜在浸润性或浸润性妇科疾病。具体而言，发现 9 例宫颈疾病（包括 1 例宫颈内膜鳞状细胞癌 pT1a）和 6 例子宫内膜增生。此外，还发现 2 例输卵管卵巢疾病。
术后宫颈狭窄是一种具有挑战性的临床情况，尤其是在因宫颈上皮内瘤变或微浸润性宫颈癌而接受治疗的女性中。结果表明，宫颈狭窄可能会阻碍充分的妇科随访和及时诊断恶性肿瘤。因此，应仔细向有宫颈狭窄的绝经后妇女提供咨询，子宫切除术可能是一种合理的选择，特别是在保守治疗不可行、失败或不被患者接受的情况下。
