Kucera H, Vytiska-Binstorfer E, Weghaupt K
Geburtshilfe Frauenheilkd. 1984 May;44(5):286-90. doi: 10.1055/s-2008-1036659.
A report is given about 207 second-look curettages 9-12 months after radiotherapy of carcinoma endometrii. In 22.7% of the cases clinical symptoms of a recurrent disease already have been observed. In 18.4% second-look curettage could not be performed because of complete obliteration of the cervical canal. Perforations occurred in 5.3%. A positive histologic result was found in 17.2%. Only 64% of all recurrent diseases 24 months after primary irradiation were detected by means of second-look curettage. Most interesting are the cases with obliteration of the cervical canal: 37 out of 38 patients showed local recidivation in the following 5 years. Regular intrauterine exfoliation smears in tumour follow-up of primary irradiated endometrial carcinomas are suggested. If this is not possible because of an obliterated cervical canal, second-look curettage must be performed. In this manner not only recidivation can be detected, but obliterations of the cervical canal with consecutive recurrent disease can also be prevented.
本文报告了207例子宫内膜癌放疗9至12个月后的二次刮宫情况。22.7%的病例已观察到复发疾病的临床症状。18.4%的病例因宫颈管完全闭塞而无法进行二次刮宫。穿孔发生率为5.3%。组织学检查阳性结果为17.2%。初次放疗24个月后，通过二次刮宫仅检测出所有复发病例中的64%。宫颈管闭塞的病例最为有趣：38例患者中有37例在接下来的5年中出现局部复发。建议对原发性放疗后的子宫内膜癌患者进行定期的子宫内脱落涂片检查以进行肿瘤随访。如果由于宫颈管闭塞而无法进行涂片检查，则必须进行二次刮宫。通过这种方式，不仅可以检测到复发，还可以预防因宫颈管闭塞而导致的连续性复发病例。
