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宫内视镜如何影响接受CIN2+的LEEP的妇女的产科结果:回顾性队列分析

Luigi Della Corte¹, Giada Lavitola², Giuseppe Bifulco²

¹Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131, Naples, Italy. dellacorte.luigi25@gmail.com.

Archives of gynecology and obstetrics

|June 1, 2023

概括

在循环电外科切除手术 (LEEP) 之前,为宫内皮瘤 (CIN2+) 进行手术前的宫内视镜检查可以减少组织去除并改善结果. 这种程序降低了可能出现的早产和流产的几率,保持了子宫健康.

科学领域:

妇科瘤学妇科瘤学
镜检查和宫病理学
产科和妇科产科和妇科

背景情况:

宫内皮质瘤 (CIN2+) 是一种需要治疗的癌前疾病.
循环电外科切除手术 (LEEP) 是CIN2+的常见治疗方法.
由于子宫损伤,LEEP的潜在并发症包括不良的产科结果.

研究的目的:

评估术前内视镜对接受LEEP治疗CIN2+的妇女产科结局和并发症的影响.
评估内视镜对LEEP组织样本大小和切除边缘的影响.
分析内视镜对子宫长度和LEEP后怀孕结果的影响.

主要方法:

追溯队列研究 (2012年10月 - 2018年4月) 涉及528名CIN2+患者.
组A (n=288):在LEEP之前接受了内视镜检查.
组B (n=240):在没有手术前内视镜的情况下接受LEEP.
经阴道超声波测量了基线,LEEP后6个月和怀孕20周的子宫长度.

主要成果:

宫内视镜组 (A) 在LEEP期间切除的组织显著减少 (6.7%与31.9%,p<0.01) 和较高的负切除边际率 (93.8%与65.6%).
在LEEP后6个月 (37.5毫米 vs 35.1毫米,p<0.01) 和怀孕20周 (36.9毫米 vs 33.5毫米,p<0.01) 的A组,子宫的长度显著增加.
乙组的威胁早产发病率显著高 (15.3%与4.2%,p<0.01) 和威胁流产的发病率显著高 (25%与4.2%,p<0.01).

结论:

术前内视镜可减少LEEP样本的大小和深度,保持健康的宫组织.
宫内镜检查确保了负边缘的完整的病变根除,降低了CIN2+妇女可能出现早产和流产的风险.
这种方法对患有2型或3型宫角柱结 (SCJ) 的女性尤其有益.

关键词:

宫内皮质瘤的发生.宫内显微镜检查宫内显微镜检查形柱状的结合点.受到流产威胁的威胁受到威胁的早产劳动.

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