Original Article
Comparison of effects of hysterectomy at two different timings in patients with high-grade squamous intraepithelial lesion
Guo Ruixia, Zhao Mengling, Feng Yun, Chu Fenfen, Zhang Miaomiao, Wang Qian
Published 2020-03-10
Cite as Chin J Pract Med, 2020,47(05): 8-11. DOI: 10.3760/cma.j.issn.1674-4756.2020.05.003
Abstract
ObjectiveTo compare the curative effects on high-grade squamous intraepithelial lesion (HSIL) by performing total hysterectomy (LTH) immediately after fast frozen section examination (FSE) and performing total hysterectomy after fast FSE frozen section examination and conventional pathological determination.
MethodsEighty-four patients with HSIL diagnosed in Pathology Department of the First Affiliated Hospital of Zhengzhou University from January 2016 to April 2017 who were going to have total hysterectomy operation were divided into two groups by their own willingness on operation. Patients in one-step operation group were given cervical cold knife conization (CKC) for FSE; if patients were diagnosed as non-cancer by FSE, patients underwent total hysterectomy immediately. Patients in two-step group underwent CKC for FSE first; if patients were diagnosed as non-cancer by FSE, clinicians ended the surgery; then, patients experienced routine pathological examination; if the results of pathological examination proved not to be cancer, patients underwent total hysterectomy; if the FSE showed a cancer result, patients underwent the radical operation of cervical cancer. The hospital stay, treatment coast, intraoperative bleeding volume, postoperative complication, anxiety degree and inappropriate rate of operation were compared between the two groups.
ResultsCompared to two-step group, one-step group had shorter hospital stay, less hospital coast, lower anxiety degree and shorter time for the first anal exhaust (P<0.05). There was no complication in one-step group; however, 6 patients (14.3%, 6/42) in two-step group had complications after operation, and the difference between the two groups was significant (P<0.05). The rate of middle-severe anxiety of two-step group was 71.4% (30/42), higher than the 31.0% (13/42) of one-step group (P<0.05). One patient in one-step group had inappropriate hysterectomy, and no inappropriate hysterectomy occurred in two-step group, and the difference between the two groups was not significant (P>0.05).
ConclusionsPerforming CKC and total hysterectomy at the same time has more advantages, however, it also has limited accuracy. Therefore, clinicians should attach importance to prevention of inappropriate hysterectomy, and investigation on high-risk of exacerbation of HSIL to guide the formulation of treatment protocol.
Key words:
Hysterectomy; High-grade intraepithelial lesion; Treatment; Fast frozen section examination; Conventional paraffin pathology
Contributor Information
Guo Ruixia
Department of Gynecology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Zhao Mengling
Department of Gynecology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Feng Yun
Department of Gynecology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Chu Fenfen
Department of Gynecology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Zhang Miaomiao
Department of Gynecology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Wang Qian
Department of Gynecology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
