Sadoul G, Algava G, Beuret T, Barbagelatta G
Nouv Presse Med. 1981;10(30):2509-12.
Conical amputation of the cervix is performed to treat intra-epithelial carcinomas of the cervix and endocervical dysplasias. The width and length of the cone can be adapted to the extent of exo- and endocervical lesions. The two main drawbacks of the operation are immediate or delayed haemorrhages and inability to watch the borderline between squamous and cylindrical epithelia, which is no longer visible. These drawbacks are not avoided with the usual technique using invaginating Sturmdorf sutures, whereas conical amputation with a CO2 laser coupled with a hand-piece rather than with a microscope provides virtually bloodless sections and rapid healing, within 3 weeks, without eschar detachment. In addition, there is no risk of secondary stenosis, and the squamous/cylindrical junction remains visible and can be examined by colposcopy, cervicovaginal smears and biopsies.
宫颈锥形切除术用于治疗宫颈上皮内癌和宫颈管发育异常。锥形切除的宽度和长度可根据宫颈外口和宫颈管病变的范围进行调整。该手术的两个主要缺点是即时或延迟出血,以及无法观察鳞状上皮和柱状上皮之间的边界,因为该边界已不可见。使用内翻式施图姆多夫缝线的常规技术无法避免这些缺点,而使用二氧化碳激光结合手持器械而非显微镜进行的锥形切除术可提供几乎无血的切面,并在3周内迅速愈合,无焦痂脱落。此外,不存在继发性狭窄的风险,鳞状/柱状交界处仍可见,可通过阴道镜检查、宫颈阴道涂片和活检进行检查。