Clinical Analysis Of Reoperations For Positive Margins After Cervical Conization For HSIL

Objective: The positive margin after cervical conization is considered to be a high risk factor for residual and recurrence of cervical lesions.And several treatment options are available for the retreatment of such patients.There is currently no uniform standard.In this study,113 consecutive patients who underwent cervical conization due to cervical lesions with positive margins were retrospectively analyzed,and after operation,patients who underwent either cervical conization or extrafascial hysterectomy were again selected,all of whom were followed up to record their recurrence rate,recurrence rate,complications,length of hospital stay,total cost,and so on,and to analyze the advantages and disadvantages of each of the two procedures,Thereby providing a basis for clinical work.Methods: From January 2014 to December 2019,cervical conization was performed in the Department of Gynecology of Wuhu Second People’s Hospital and Nanling County hospital due to cervical lesions.Postoperative pathology showed that the cutting edge was positive,and cervical conization or extrafascial hysterectomy was performed again from 2 to 4 months after cervical conization.Among them,30 cases chose to conization again,83 cases chose extrafascial hysterectomy,There were 113 cases in the two groups.The hospitalization time,total cost,residual lesions,recurrence and complications of the two groups were compared and analyzed.Results: General clinical parameters of both patient groups: in terms of age,the conization group 39.8 ± 3±± 7.36 years in the subfascial hysterectomy group and45.13±And 4.46 years,respectively,the difference was statistically significant.There were no significant differences between the two groups in terms of pregnancy,birth,menopause,presence of human papilloma virus(HPV)and thinprep cytologic test(TCT)of cervical fluid,residual and recurrent cervical lesions after reoperation,persistent postoperative HPV infection,length of hospital stay or There were statistically significant differences in total costs and postoperative complications.Conclusion: Cervical conization and extrafascial hysterectomy are equally effective in treating patients with positive margins after cervical conization for HSIL,with shorter hospital stays,costs and lower complication rates in the former;Re operation for positive margins after HSIL cervical conization,if there is no difficulty in re cervical conization,cervical conization is recommended;If re cervical conization is difficult,an extrafascial hysterectomy may be an option;...