Excisional treatments for cervical intraepithelial neoplasias

• Nina V. Zarochentseva
• Lela K. Dzhidzhikhia
• Yulia N. Bashankaeva
• Vusala N. Nabieva

Abstract

Every year around 2.5-3 million cases of human papillomavirus infection (HPV) are diagnosed in the world. For the treatment of precancerous Lesions of the cervix HSIL, CIN2/CIN3, classical excisional methods of treatment are used: conization, LEEP excision (Loop Electrosurgical Excision Procedure), LLETZ excision (Large loop excision of Transformation zone) and NETZ (Needle versus Loop diathermy excision of the transformation zone). Modern excision techniques include contour-Loop excision of the transformation zone (C-LETZ), Local excision of the affected area, and double excision. The radio wave method of excision, conization is oncological safe, it allows adequate removal of the affected area with minimal thermal damage to the surrounding tissues, which improves repair and preserves the reproductive function of women. The most common complications after excisional treatments for CIN include postoperative bleeding, which occurs up to 10% after stab conization. Partial or complete stenosis of the cervical canal is observed less often - in 3-5% of cases after electrocoagulation or conization with a cold knife. The main disadvantage of laser coagulation is the impossibility of an adequate morphological assessment of the entire affected area due to coagulation of the incision area. The minimum number of complications is observed during treatment with the radio wave method.

Recurrences of CIN2+ within 2 years after treatment averaged 7% of cases with rates varying from 2.5% to 18% and aggravated depending on the depth of the lesion.

Monitoring of patients after application of excisional methods of treatment of cervical intraepithelial neoplasias includes joint cytological examination and HPV testing in dynamics.

Keywords:intraepithelial neoplasia of the cervix, CIN, LEEP, LLETZ, excisional methods of treatment, human papillomavirus, complications, follow-up after treatment

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