Author/Editor		Bertole, Jože
Title		Uporabnost cervikoskopije pri odkrivanju in zdravljenju cervikalnih intraepitelijskih neoplazij
Translated title		Usefulness of cervicoscopy in detection and treatment of cervical intraepithelial neoplasia
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 69, št. 10
Publication year		2000
Volume		str. 667-71
Language		slo
Abstract		Background. In spite of more recent modes of treatment (CO2 laser, diathermic loop) conization is still the treatment of choice for severe cervical intraepithelial neoplasia (CIN III). The results of numerous studies on the harmful effect of conization on the cervix are rather variable, yet the majority of the studies confirm this harmful effect. The height of the removed cone is one of the causes for the affected cervix following conization. Namely, a substantial proportion of the healthy tissue from the vicinity of the internal cervical os is removed as well and this tissue is considered the closure mechanism of the uterine cavity. Therefore, by reducing the height of the cone it could be possible to decrease the harmful effect of conization. The sufficient height of the cone can be determined only if the spread of the pathologic changes into the cervical canal is known. This knowledge can only be obtained by cervicoscopy. The aim of the study was to find whether by using cervicoscopy for conization the removal of the entire diseased tissue was possible paying every attention to remove as little healthy cervical tissue as possible. Patients and methods. In the study we enrolled 205 patients who underwent conization for CIN III at the Department of Obstetrics and Gynecology Ljubljana in the period 1994-1998. In the study group there were 102 patients and in the control group 103. The study group population underwent cervicoscopy prior to conization to be able to determine the height of the cone to be removed. In the control group patients conization alone was performed. In the study group the following measurements were done: the height of the lesion into the cervical canal by cervicoscopy, the height of the cone by surgery, the height of the lesion and the height of the cone by laboratory analyses. The data for the control group were collected retrospectively; all the measurements were done in the laboratory only (Abstract truncated at 2000 characters.)
Summary		Izhodišča. Pri cervikalnih intraepitelijskih neoplazijah (CIN) je konizacija kljub nekaterim novejšim načinom (CO2 laser, diatermična zanka) še vedno izbirna metoda zdravljenja. Rezultati številnih raziskav o škodljivem vplivu konizacije na maternični vrat se sicer med seboj precej razlikujejo, vendar prevladujejo tiste, ki ta vpliv potrjujejo. Med vzroke za prizadetost materničnega vratu po konizaciji prištevamo tudi visoke konuse, s katerimi odstranimo precej zdravega tkiva materničnega vratu v bližini notranjega materničnega ustja, ki velja za zaporni mehanizem maternične votline. Z zmanjšanjem višine konusa bi bilo zato morda mogoče škodljive posledice konizacije omiliti. Ustrezno višino konusa pa lahko določimo samo, če vemo, kako visoko v kanal materničnega vratu sega bolezenska sprememba. Ta podatek je mogoče dobiti s cervikoskopijo. Namen raziskave je bil ugotoviti, ali je s pomočjo cervikoskopije mogoče cervikalno intraepitelijsko neoplazijo pri konizaciji v celoti odstraniti tako, da je s konusom odstranjenega čim manj zdravega tkiva materničnega vratu. Preiskovanke in metode dela. V raziskavo smo vključili 205 bolnic, pri katerih je bila na Ginekološki kliniki v Ljubljani v obdobju od leta 1994 do 1998 narejena konizacija zaradi CIN III. V študijski skupini sta bili 102 bolnici, v kontrolni skupini pa 103 bolnice. V študijski skupini smo merili cervikoskopsko višino spremembe v kanalu materničnega vratu, operativno višino konusa, laboratorijsko višino spremembe in laboratorijsko višino konusa. V kontrolni skupini so bili podatki zajeti retrospektivno in smo merili cervikoskopsko višino spremembe v kanalu materničnega vratu, operativno višino konusa, laboratorijsko višino spremembe in laboratorijsko višino konusa. V kontrolni skupini so bili podatki zajeti retrospektivno in smo meritve opravili le v laboratoriju. Izmerili smo višine konusov in višine sprememb v njih. (Izvleček prekinjen pri 2000 znakih.)
Descriptors		CERVICAL INTRAEPITHELIAL NEOPLASIA ADULT CONIZATION HYSTEROSCOPY