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目的:探讨宫颈病变锥切术后切缘阳性或病理升级患者补充手术的必要性和合适的处理方法。方法:回顾性分析2000年8月～2006年8月中45例宫颈病变冷刀锥切术或电热圈锥切术后再补充手术的临床资料,并将锥切术后的病理与补充后病理进行分析比较。结果:45例锥切病人中切缘阳性者8例,病理升级者37例。该45例患者全部补充了手术,术后病理中35例(77.8%)无病变,7例(15.6%)病理降级,3例(6.67%)与再次手术前病理相符,无1例出现病理升级。结论:宫颈锥切术后病理为浸润癌者需补充手术治疗,而术后病理升级为更高级别的C IN或宫颈原位癌,或切缘阳性者可对其进行HPV和细胞学随访而不需补充手术治疗。
Objective: To investigate the necessity and appropriate treatment of surgical resection in patients with positive cervical margin or pathological upgrade after cervical conization. Methods: The clinical data of 45 cases of cervical lesion cold taper conization or electrothermal coil conization after augmentation surgery from August 2000 to August 2006 were retrospectively analyzed. The pathological and postoperative pathological changes after conization For analysis and comparison. Results: Among the 45 patients with conization, there were 8 cases with positive edge and 37 cases with pathological upgrade. All of the 45 patients were completely surgically treated. No pathological changes were found in 35 cases (77.8%), 7 (15.6%) pathologically, 3 (6.67%) were consistent with reoperation, . CONCLUSIONS: Pathological invasive ductal carcinoma following surgical conization of the cervix requires surgical treatment, and postoperative pathological changes to a higher grade of CIN or cervical carcinoma in situ may be followed up with HPV and cytology No additional surgical treatment.