Cytologic Follow-up, Complications, and Sequelae for Two Open Techniques of Cold Knife Conization

1987 ◽  
Vol 3 (4) ◽  
pp. 183-189 ◽  
Author(s):  
MARIANNE E. BUYZE-WESTERWEEL ◽  
J. BAPTIST TRIMBOS ◽  
RONALD BRAND ◽  
LEX A.W. PETERS ◽  
GERT-JAN FLEUREN
Keyword(s):  
Cold Knife ◽  
Cold Knife Conization

Clinical Value of Cold Knife Conization as Conservative Management in Patients With Microinvasive Cervical Squamous Cell Cancer (Stage IA1)

2014 ◽  
Vol 24 (7) ◽  
pp. 1306-1311 ◽  
Author(s):  
Yue He ◽  
Yu-Mei Wu ◽  
Qun Zhao ◽  
Tong Wang ◽  
Yan Wang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Squamous Cell Cancer ◽  
Cell Cancer ◽  
Resection Margins ◽  
Clinical Value ◽  
Fertility Sparing ◽  
Cold Knife ◽  
Positive Resection Margins ◽  
Cold Knife Conization

ObjectiveThe aim of the study is to evaluate the clinical value of cold knife conization (CKC) as a conservative management in patients with microinvasive cervical squamous cell cancer (SCC).MethodsThis retrospective study enrolled 108 women with diagnosis of microinvasive cervical SCC (stage IA1) by pathology between 2009 to 2012 at Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Eighty-three patients underwent further hysterectomy.ResultsOf the 83 patients (76.9%) who underwent further hysterectomy, 48 patients (57.8%) underwent extrafascial hysterectomy, 30 patients (36.1%) underwent extensive hysterectomy, and 5 patients (6.1%) underwent radical hysterectomy. A total of 19 patients underwent pelvic lymph node dissection without any lymph node metastasis, and a total of 5 patients (4.6%) had lymph vascular space invasion without any positive pelvic lymph node dissection. Of the 83 patients who underwent further hysterectomy and were followed up for 1 year, 18 patients with positive resection margins indicating cervical residual lesions (CIN1-3) have greater likelihood than 65 patients with clear resection margins, but there were no significant differences (P= 0.917); of the 25 patients who underwent CKC as final therapy and were followed up for 1 year, 2 patients with positive resection margins had the second CKC surgery, 1 was diagnosed with CIN1, and the other was diagnosed with cervicitis by pathology; 23 patients had clear resection margins, 2 patients underwent the second CKC 3 months after the first CKC because of the abnormal Thinprep Cytologic Test (TCT) result, and they were both diagnosed with microinvasive cervical SCC (stage IA1) by pathology with clear resection margins. No one enrolled in this study presented metastasis and progression within 1 year of follow-up.ConclusionsThese findings provide the clinical evidences for the possibility of fertility-sparing treatments, especially CKC as conservative treatment for microinvasive cervical SCC. Appropriate further treatments (the second CKC) and follow-up are recommended for patients who strongly desire fertility sparing.

The value of loop electrosurgical conization in the treatment of stage IA1 microinvasive carcinoma of the uterine cervix

2002 ◽  
Vol 12 (5) ◽  
pp. 485-489 ◽  
Author(s):  
R. L. M. Bekkers ◽  
K. G. G. Keyser ◽  
J. Bulten ◽  
A. G. J. M. Hanselaar ◽  
C. P. T. Schijf ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Uterine Cervix ◽  
Figo Stage ◽  
Outpatient Procedure ◽  
Number Of Patients ◽  
Cold Knife ◽  
Cold Knife Conization ◽  
Microinvasive Carcinoma ◽  
Second Procedure

The objective of this study is to assess the value of Loop Electrosurgical Conization (LEC) in the treatment of stage IA1 microinvasive squamous cell carcinoma (MIC) of the uterine cervix. Retrospectively, 82 patients with FIGO stage IA1 MIC, primarily treated with LEC on see and treat basis, were analyzed.After the initial LEC, 16 patients received cytologic and colposcopic follow-up only, 66 patients underwent a second procedure (repeat LEC, Cold Knife Conization (CKC), or hysterectomy), and four patients underwent a third procedure (hysterectomy). In 63 patients (77%) no residual CIN 3 or MIC was present after the initial LEC. Treatment of residual CIN 3 or MIC was equally effective with a repeat LEC as with CKC. One patient defaulted follow-up and developed a recurrence in the vaginal vault and was treated with a radical hysterectomy.LEC can be used as an alternative for CKC in treatment of patients with stage IA1 MIC. The advantage of LEC is that it can be performed as an outpatient procedure in addition to a diagnostic colposcopy and does not require a major anesthetic. Only a small number of patients will need a more extensive procedure.

scholarly journals The role of human papillomavirus (HPV) testing in the follow-up of patients after treatment for cervical intraepithelial neoplasia (CIN)

2013 ◽  
Vol 3 (2) ◽  
pp. 117-122
Author(s):  
Goran Dimitrov ◽  
Elena Dzikova ◽  
Gligor Dimitrov ◽  
Saso Panov ◽  
Irena Aleksioska ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Intraepithelial Neoplasia ◽  
Hpv Testing ◽  
Normal Cytology ◽  
Gynecology And Obstetrics ◽  
Number Of Patients ◽  
Cold Knife ◽  
Cold Knife Conization

Introduction: The aim of this study was to examine the role of human papillomavirus testing in the follow-up after treatment for CIN, as a prognostic sign for residual/recurrent cervical precancerous lesions.Methods: A hospital-based analysis was performed on 460 patients previously treated for CIN with cold knife conization, at the University Clinic for Gynecology and Obstetrics and General Hospital Remedika, in Skopje, Republic of Macedonia, in a period of 3 years. The patients were followed-up with HPV testing in addition to cytology, colposcopy and/or biopsy. The first after treatment HPV testing was performed8 months after cold knife conization, proceeded by follow-up within 24 months after treatment, at 4 months intervals.Results: Among 460 treated patients, at the fi rst HPV and cytologic testing, 8 months after treat-ment, 69 (15%) were HPV+, and 391 (85%) HPV negative. From the 69 HPV+ patients, 41 (59.4%) were withcytologic abnormalities and 28 (40.6%) without abnormalities. 12 months after treatment, the number of HPV+ patients developing cytologic abnormalities raised to 45/70 (64.29%). Within the 24 months aftertreatment, the number of patients who had recurrent/ residual CIN from the HPV+ patients reached 50/71 (70.42%); which was 10.87% from all 460 treated patients.Conclusion: Persistence or clearance of HPV especially 8 months after treatment even in patients with normal cytology, is an early valid prognostic marker of treatment failure, and is more accurate than cytologyat the same follow-up intervals.

Necessity for subsequent surgery in women of child-bearing age with positive margins after cold knife conization: A retrospective cohort study

2021 ◽  
Author(s):  
Xinmei Wang ◽  
Juan Xu ◽  
Yang Gao ◽  
Pengpeng Qu
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
High Grade ◽  
Transformation Zone ◽  
Positive Margins ◽  
Child Bearing ◽  
Significant Difference ◽  
Cold Knife ◽  
Cold Knife Conization ◽  
Residual Lesions

Abstract Background: Risk factors for positive margins and residual lesions after cold knife conization (CKC) for high-grade cervical intraepithelial neoplasias (CIN) were assessed in women of child-bearing age. A design for postoperative management and avoiding these situations is offered.Methods: This was a retrospective study on 1,309 premenopausal women with high-grade CIN (including CIN3 and CIN2) based on a cervical biopsy under colposcopy used to diagnose a positive or negative margin. Age, gravidity, parity, HPV species, cytology, transformation zone type, results of endocervical curettage (ECC), quadrant involvement, glandular involvement, and CIN grade were analyzed. Among those with positive margins, 245 underwent surgery within three months, including CKC, a loop electrosurgical excision procedure, and total hysterectomy. Residual lesions were also assessed.Results: There was no significant difference in age, gravidity, parity, glandular involvement, and CIN grade between the two groups (P>0.3). There was a significant difference in HPV species, cytology, ECC results, and quadrant involvement (P<0.002). Multivariate analysis showed a major cytology abnormality, high-risk HPV infection, type III transformation zone, positive ECC result, and multiple quadrant involvement were independent risk factors for positive margins and residual lesions (P<0.02). Age >35 years was also a risk factor (P<0.03).Conclusion: High-risk women should be treated appropriately considering fertility. Patients with positive margins should be managed uniquely. Surgery for women without fertility may be appropriate. Close follow-up is necessary for women who have fertility requirements or are unwilling to undergo subsequent surgery if they have no risk factors, especially for women <35 years.

Bloodless technique of cold knife conization (ring biopsy)

1960 ◽  
Vol 79 (1) ◽  
pp. 62-66 ◽  
Author(s):  
Joseph W. Scott ◽  
William B. Welch ◽  
Thomas F. Blake
Keyword(s):  
Cold Knife ◽  
Cold Knife Conization

CO2 Laser Conization for Cervical Intraepithelial Neoplasia: A Comparison with Cold Knife Conization During Pregnancy

1991 ◽  
Vol 9 (2) ◽  
pp. 115-120 ◽  
Author(s):  
Masashi Moriyama ◽  
Osamu Iwanari ◽  
Satoru Nakayama ◽  
Naoki Yoshino ◽  
Yoshie Date ◽  
...  
Keyword(s):  
Cervical Intraepithelial Neoplasia ◽  
Co2 Laser ◽  
Intraepithelial Neoplasia ◽  
Cold Knife ◽  
Cold Knife Conization

Cold-knife conization versus conization by the loop electrosurgical excision procedure: A randomized, prospective study

1999 ◽  
Vol 180 (2) ◽  
pp. 276-282 ◽  
Author(s):  
Bridgette D. Duggan ◽  
Juan C. Felix ◽  
Laila I. Muderspach ◽  
Judith A. Gebhardt ◽  
Susan Groshen ◽  
...  
Keyword(s):  
Prospective Study ◽  
Cold Knife ◽  
Cold Knife Conization ◽  
Loop Electrosurgical Excision ◽  
Loop Electrosurgical Excision Procedure
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