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Korean Journal of Obstetrics & Gynecology 2005;48(11):2586-2593.
Published online November 1, 2005.
Follow-up of Cervical Intraepithelial Neoplasia after Conization: The Clinical Usefulness of Repeat Conization.
Byung Sub Shin, Dong Hyung Lee, Ki Hyung Kim, Man Soo Yoon, Ook Hwan Choi
Department of Obstetrics and Gynecology, Pusan National University, School of Medicine, Busan, Korea. ohchoi@pusan.ac.kr
Abstract
OBJECTIVE
This study is aimed to analyze the results of follow up after conization and to determine the value of repeat conization for treatment of cervical intraepithelial neoplasia (CIN) III. METHODS: Between March 1998 and February 2002, 241 women were underwent knife conization due to CIN III of the uterine cervix. After knife conization, follow-up visits were scheduled at 2 weeks interval during the first 3 months for cervical inspection only, then at every 3 months for the first year, every 6 months for the second year, and then annually for pelvic examination and Papanicolaou smears. Among 241 patients, 71 women were suspected of residual or recurrent lesions by cytology and colposcopy. Among 71 patients with residual or recurrent lesions, 37 patients received simple hysterectomy and 34 patients received repeat conization. RESULTS: The mean age of the patients was 36.4 years (range 27-64) and mean parity was 2 (range 0-6). The mean follow-up duration was 25.4 months (range 14-51) after conization. The results of repeat conization (n=34) were as follows; no residual lesion in 7 patients, CIN III in 15 patients, and lower grade neoplasia in 12 patients. Two patients were margin positive; 1 patient with CIN III, 1 patient with lower grade neoplasia. The outcomes of simple hysterectomy (n=37) were as follows; no residual lesion in 8 patients, CIN III in 18 patients, and lower grade neoplasia in 11 patients. Resection margin negative rates of repeat conization and simple hysterectomy were 94.1% and 100%, respectively (p>0.05). CONCLUSION: This study suggests that less invasive technique such as repeat conization might be an alternative method instead of hysterectomy in selected patients with recurrent or residual lesions who wish to preserve fertility.
Key Words: Cervical intraepithelial neoplasia, Follow up, Repeat conization


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