• 作者：Borja Rivero^a ; ^{BRIVEROD@telefonica.net} ; Mikel Gorostidi^b ; Daniel Andia^c ; Enrique Izaguirre^d ; Javier Diez^e ; Carlos Pé ; rez^f ; José ; Ignacio Olabarri^g ; Aloñ ; a Elorza^h ; José ; Ramó ; n Serranoⁱ ; Emerson Murua^j
• 关键词：Conizaci&oacute ; n ; Neoplasias cervicales uterinas ; Displasias cervicales uterinas
• 刊名：Progresos de Obstetricia y Ginecolog¨ªa
• 出版年：2010
• 出版时间：March 2010
• 年：2010
• 卷：53
• 期：3
• 页码：93-101
• 全文大小：160 K

Objective

The main objective of this study was to evaluate the conization technique used in Basque Country hospitals and to determinate the most appropriate place to perform this procedure (outpatient clinic or operating room) by evaluating pain, early and late complications and histological results.

Materials and methods

We selected 232 patients with a cytologic and colposcopic diagnosis of cervical dysplasia requiring surgical cervical conization between September 2006 and July 2007 in eight public hospitals of the Basque Country.

Results

A total of 94.8 % of conizations were performed with long loop excision of transformation zone (LLETZ) and, exceptionally, with cold knife conization. Local anesthesia was used in tertiary hospitals and regional anesthesia in county hospitals. Pain tolerance in outpatient conization with LLETZ under local anesthesia was excellent. In Hospital Donostia, pain was scored on a visual analogue scale and low scores were achieved, in accordance with the high degree of satisfaction obtained with the procedure. Conization margins depended on the grade of dysplasia rather than on the technique. There were few early complications and even fewer late complications.

Conclusion

The LLETZ method performed under local anesthesia in the outpatient clinic is very well tolerated by patients and has few complications. Consequently, this option is a valid alternative to conization under general or regional anesthesia. The LLETZ technique provides multiple advantages for the patient and health service due to its lower cost, without medical disadvantages, and satisfactory tolerance.