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首页> 外文会议>2011 Asia-Pacific Conference of tumor biology and medicine >ANALYSIS OF 79 CASES OF TRANSVAGINAL EXTERNAL FASCIA TRACHELECTOMY
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ANALYSIS OF 79 CASES OF TRANSVAGINAL EXTERNAL FASCIA TRACHELECTOMY

机译：经阴道外筋膜透皮镜检查79例分析

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Objectives To explore the feasibility and safety about the surgery__transvaginal external fascia trachelectomy to conservatively treat stage Ial squamous carcinoma of the cervix (SCC) and cervical intraepithelial neoplasia(CIN) III that's not suitable to take cold knife conization(CKC). Methods From July 2002 to April 2011, those patients who have a strong desire to salvage uterine or fertility but also are confronted with following situations received transvaginal external fascia trachelectomy, CIN III with large lesion (colposcopically observed lesion is larger than 3/4 of the cervix), or patients with CIN II-III suffered recurrence or had persistent lesion or positive margin after CKC or LEEP, or patients with CIN II- III upgraded into stage Ial SCC through LEEP and pathological confirmation (except for those with lymphovascular space invasion), or CIN III patients complicated with upper vaginal intraepithelial neoplas'ia(VAIN), Their clinical information and data were reviewed and analyzed. Results 83 patients took this surgery successfully but 4 of them exited this research in that they upgraded into stage Ibl SCC after postoperative pathological confirmation. In the remaining 79 cases, 6 are stage Ial SCC, 61 are CIN III with a large lesion (23 cases are glandulous involvement), 3 are CIN III complicated with VAIN, 6 are CIN III with persistent lesion after LEEP and 2 are CIN III with positive margins after LEEP. The median age of these patients is 33y, ranging from 23 to 40. The mean operation time is 39min (rang 2060min), the average amount of bleeding is 40ml (rang 1 -300ml) and the mean hospital stay is 10d( rang 617d). The median follow-up time is 49m(8-85m) and none of these patients has large amount of intraoperative or post-operative hemorrhage or postoperative recurrence. No one complains any effect on sexual life. Among the 5 patients with reproductive desire, one is in her 22w gestation after one induced abortion and one spontaneous abortion, 4 patients experienced term birth in which three are cesarean section and one is natural labour. Conclusions Transvaginal external fascia trachelectomy is a safe and effective treatment for stage Ial SCC, CIN III with large lesion, CIN III complicated with VAIN and CIN II-III suffering recurrence, persistent lesion or positive margins after CKC and others that are not suitable to take CKC.
机译：目的探讨经阴道外筋膜气管切开术保守治疗不适合采用冷刀锥切术（CKC）的Ial期宫颈鳞状上皮癌（SCC）和宫颈上皮内瘤样变（CIN）III的可行性和安全性。方法2002年7月至2011年4月，那些渴望挽救子宫或生育能力但又面临以下情况的患者接受经阴道外筋膜气管切开术，大病变CIN III（阴道镜检查发现病变大于3/4的病灶）。子宫颈），或CIN II-III患者在CKC或LEEP后复发或出现持续性病变或切缘阳性，或CIN II-III患者通过LEEP和病理学确诊升级为Ial SCC期（淋巴血管侵犯的患者除外）或CIN III并发上阴道上皮内瘤变（VAIN）的患者，对其临床信息和数据进行了回顾和分析。结果83例患者成功手术，但其中4例因术后病理证实升级为Ibl SCC期而退出研究。在其余的79例中，Ial SCC期为6例，大病变为CIN III（23例为腺体受累），CIN III并发VAIN，LEEP后有持续病变的CIN III为6例，CIN III为2例。 LEEP之后的利润为正。这些患者的中位年龄为33y，范围为23至40。平均手术时间为39min（范围为2060min），平均出血量为40ml（范围为-300ml），平均住院时间为10d（范围为617d）。 。中位随访时间为49m（8-85m），这些患者中无术中或术后大出血或术后复发。没有人抱怨对性生活有任何影响。 5例有生殖欲的患者中，1例因人工流产和1例自然流产后22周妊娠，4例足月分娩，其中3例剖宫产，1例自然分娩。结论经阴道外筋膜气管切开术是治疗Ial期SCC，CIN III大病变，CIN III并发VAIN和CIN II-III复发，持续病变或CKC后切缘阳性或其他不适合服用的安全有效的治疗方法CKC。

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