Clinical comparative study of transcervical resection of cervical lesion and cervical cold knife conization in treatment of cervical intraepithelial neoplasia 2 in postmenopausal women

Abstract

Objective To investigate the intraoperative and postoperative parameters of transcervical resection of cervical lesion (TCRC) and cervical cold knife conization (CKC) in treatment of cervical intraepithelial neoplasia (CIN) 2 in postmenopausal women. Methods A total of 60 postmenopausal women with CIN2 who were hospitalized in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from October 2010 to March 2018, were chosen as research subjects. According to the received surgical method for CIN2 patients, they were divided into TCRC group (n=30, patients received TCRC) and CKC group (n=30, patients received cervical CKC). With the retrospective clinical comparative study, the general clinical data, operative duration, amount of intraoperative blood loss, hospitalization duration after operation, postoperative vaginal bleeding, postoperative cut edge positive rate of specimen, infection condition after operation, and coincidence rate of preoperative and postoperative pathological results were statistically compared between two groups of patients by independent-samples t test or chi-square test. The study met the requirements of World Medical Association Declaration of Helsinki revised in 2013. Results ①There were no significant differences between two groups of postmenopausal patients with CIN2 in patients′ age, menopausal age, menopausal time, preoperative human papilloma virus (HPV) positive rate and preoperative thinprep cytologic test (TCT) result (P>0.05). ②The patients in two groups were operated successfully, and presented neither local infection nor systemic infection after operation. The operative duration, amount of intraoperative blood loss and hospitalization duration after operation in TCRC group were (20.7±9.6) min, (11.5±6.8) mL, (2.3±1.3) d, which were all shorter or less than those in CKC group, which were (34.5±8.2) min, (36.0±18.7) mL, (4.1±1.4) d, and the differences were statistically significant (t=5.981, 6.731, 5.133; P 0.05). Conclusions TCRC in the treatment of CIN2 in postmenopausal women has several advantages of less amount of intraoperative blood loss, shorter operative time and faster recovery of patients than cervical CKC. It is a visual, minimally invasive and safe treatment method. Key words: Uterine cervical neoplasms; Hysteroscopes; Cervical intraepithelial neoplasia; Precancerous conditions; Menopause; Transcervical resection of cervical lesion; Cold knife conization; Female