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Vol. 47. Núm. 6.
Páginas 272-277 (enero 2004)
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Vol. 47. Núm. 6.
Páginas 272-277 (enero 2004)
Acceso a texto completo
Conización cervical: conocimientos actuales y evaluación de las diferentes técnicas quirúrgicas
Cervical conization: current knowledge and evaluation of different surgical techniques
Visitas
32113
D. Rubio
Autor para correspondencia
rubiol@jazzfree.com

Correspondencia: Servicio de Ginecología. Hospital Universitario Ramón y Cajal. Crta. Húmera, 87, P-15 2.° A. 28223 Pozuelo de Alarcón. Madrid. España
, M. González, M.A. Prieto, J.J. Paniagua, M. de Nicolás
Servicio de Ginecología. Hospital Universitario Ramón y Cajal. Madrid. España
Este artículo ha recibido
Información del artículo
Resumen
Objetivo

Análisis comparativo de las diferentes técnicas de conización cervical: bisturí frío, asa de diatermia y láser CO2.

Material y métodos

Hemos estudiado 340 pacientes sometidas a conización cervical. Las técnicas empleadas fueron en 171 casos (50%) bisturí frío, en 131 (38,5%) láser CO2y en 38 (11,2%) asa de diatermia.

Resultados

No encontramos diferencias estadísticamente significativas entre las técnicas utilizadas: bisturí frío, asa de diatermia y láser en el análisis de los márgenes quirúrgicos afectados (17 frente a 10,5 frente a 10%), tamaño del cono y complicaciones hemorrágicas postoperatorias (3,5 frente a 2,6 frente a 4,5%).

Conclusiones

La técnica utilizada, de acuerdo con los resultados obtenidos, no parece influir en las características del cono ni en las complicaciones.

Palabras Clave:
Conización
Cono
Bordes
Abstract
Objective

To compare three techniques of cervical conization: cold knife, loop diathermy and laser CO2.

Material and methods

We studied 340 patients treated with cervical conization. The techniques used were: cold knife in 171 patients (50%), laser CO2in 131 (38.5%) and loop diathermy in 38 (11.2%).

Results

No statistically significant differences were found among cold knife, loop diathermy and laser in the analysis of surgical margins (17% vs 10.5% vs 10% ), cone size or postoperative hemorrhagic complications (3.5% vs 2.6% vs 4.5%).

Conclusions

The results suggest that the technique used does not influence cone characteristics or complications.

Key Words:
Conization
Cone
Margins
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Bibliografía
[1.]
G. López García, M.J. Acosta Vázquez.
Conización con bisturí frío de la CIN en Neoplasia Cervical intraepitelial.
pp. 509-517
[2.]
I. Kaplan, J. Goldman, R. Ger.
The treatment of erosions of the uterine cervix by means of the CO2 laser.
Obstet Gynecol, 41 (1973), pp. 795-796
[3.]
J.M. Dorsey, E.S. Diggs.
Microsurgical conization of the cervix by carbon dioxide laser.
Obstet Gynecol, 54 (1979), pp. 565-570
[4.]
E.S. Andersen, B. Pedersen, K. Nielsen.
Laser conization: the results of treatment of cervical intraepithelial neoplasia.
Gynecol Oncol, 54 (1994), pp. 201-204
[5.]
P. Mathevet, D. Dargent, M. Roy, G. Beau.
A randomised prospective study comparing three techniques of conization: cold knife, laser and LEEP.
Gynecol Oncol, 54 (1994), pp. 175-179
[6.]
R. Palmer.
Les dysplasies du musean de tanche et leur traitement par la biopsie exerese a lánse diathermique.
Soc Fr Gynecol, 23 (1953), pp. 43-49
[7.]
R. Cartier, B. Sopena, Y. cartier.
Use of the diathermy loop in the diagnosis and treatment of lesions of the uterine cervix; 4th World Congress Int Fed Cervical Pathology and colposcopy.
Londres, (1981),
[8.]
W. Prendiville, J. Cullimore, S. Norman.
Large loop excision of the transformation zone (LLETZ). A new method of management for women with cervical intraepithelial neoplasia.
Br J Obstet Gynecol, 96 (1989), pp. 1054-1060
[9.]
W. Prendiville.
Large loop excisión of the transformation zone. Bailliere’s Cin Obstet.
Clin Obstet Gynecol, 9 (1995), pp. 189-220
[10.]
F.W. Abdul-Karin, Y.S. Fu, J.W. Reagan, W.B. Wentz.
Morphometric study of intraepithelial neoplasia of the uterine cervix.
Obstet Gynecol, 60 (1982), pp. 210-214
[11.]
R. Labastida Nicolau, M. Cararach Tur, A. Úbeda Hernández.
Láser en patología cervical en neoplasia cervical intraepitelial.
pp. 479-506
[12.]
H. Boonstra, J.G. Aalders, J. Koudstaal, J.W. Oosterhuis, J. Janssens.
Minimum extension and appropriate topographic position of tissue destruction for treatment of cervical intraepithelial neoplasia.
Obstet Gynecol, 75 (1990), pp. 227-231
[13.]
R. Rome, W. Charen, A. Ostor.
Preclinical cancer of the cervix: diagnostic pitfalls.
Gynecol Oncol, 22 (1985), pp. 302-312
[14.]
M. Bertrand, G.M. Lickrish, T.J. Colgan.
The anatomic distribution of cervical adenocarcinoma in situ: implications for treatment.
Am J Obstet Ginecol, 157 (1994), pp. 21-25
[15.]
J.E. Cullimore, D.M. Luesley, T.P. Rollason, P. Byrne, C.H. Buckley, M. Anderson, et al.
A prospective study of conization of the cervix in the management ofcervical intraepithelial glandular neoplasia (CIGN). A preliminary report.
Br J Obstet Gynecol, 99 (1992), pp. 314-318
[16.]
E. Burghardt, E. Holzer.
Treatment of carcinoma in situ. Evaluation of 1609 cases.
Obstet Gynecol, 55 (1980), pp. 539-545
[17.]
A. Ferenczy.
Management of the patient with an abnorrmal Pappanicolau test.
Obstet Gynecol Clin N Am, 20 (1993), pp. 189-202
[18.]
D.M. Luesley, J. Cullimore, C.W. Redman, F.G. Lawton, J.M. Emens, T.P. Rollason, et al.
Loop diathermy excision of the cervical transformation zone in patients with abnormal cervical smears.
Br Med J, 300 (1990), pp. 1690-1693
[19.]
J.A. Vidart, M. Cristóbal, M.A. Herraiz, M. Escudero.
Avances en la terapéutica con láser en tracto genital femenino.
Ciencia Ginecológica, 1 (1997), pp. 41-55
[20.]
C.V. Wright, R. Davies, M.A. Riopelle.
Laser surgery for CIN: principles and results.
Am J Obstet Gynecol, 145 (1983), pp. 181
[21.]
R. Barrasso, C. Zanardi, B. Huynh, A. Ferenczy.
Cervix and vagina: treatment. En: Human papilloma virus infection. A clinical atlas.
pp. 277-287
[22.]
G. Larsson, B. Gullberg, H. Grundsell.
A comparision of complications of laser and cold knife conization.
Obstet Gynecol, 62 (1983), pp. 213-217
[23.]
J. Delmore, D.V. Horbelt, K.J. Kallail.
Cervical conization: cold knife and laser excision in residency training.
Obstet Gynecol, 79 (1992), pp. 1016-1019
[24.]
G. De Palo, W. Charen, S. Dexeus.
Cuello uterino en patología y tratamiento del tracto genital inferior.
pp. 1-143
[25.]
E. Burghart.
Technique and place of cervical conization.
Clin Obstet Gynecol, 25 (1982), pp. 849-861
[26.]
J.R. Van Nagell, J.C. Parker, L.P. Hicks, G. Conrad Rengland.
Diagnostic and therapeutic efficacy of cervical conization.
Am J Obstet Ginecol, 124 (1976), pp. 134-139
[27.]
M. Ahlgren, I. Ingermarsson, L.G. Lindberg, S.R.B. Nordqvis.
Conization as treatment of carcinoma in situ of the uterine cervix.
Obstet Gynecol, 46 (1975), pp. 135-148
[28.]
G. Larsson, P. Alm, H. Grundsell.
Laser conization versus cold knife conization.
Surg Gynecol Obstet, 59 (1982), pp. 59-61
[29.]
E. Bostofte, A. Berget, J.F. Larsen, P.H. Pedersen, F. Rank.
Conization by carbon dioxide laser or cold knife in the treatment of cervical intraepithelial neoplasia.
Act Obstet Gynecol Scand, 65 (1986), pp. 199-202
[30.]
N. Husseinzadeh, I. Shbaro, T. Wesseler.
Predictive value of cone margins and post-cone endocervical curettage with residual disease in subsequent hysterectomy.
Ginecol Oncol, 33 (1989), pp. 198-200
[31.]
K.G.G. Keijer, P. Kenemans, P. Van der Zanden, C.P.T. Schijf, G.P. Vooijs, R. Rolland.
Diathermy loop escisión in the management of cervical intraepithelial neoplasia: diagnosis and treatment in the procedure.
Am J Obstet Gynecol, 166 (1992), pp. 1281-1287
[32.]
G. Bandieramonte, S. Lomonico, P. Quattrone, B. Stefanon, M. Merola, A. Bucci.
Laser conization assisted by crypt visualization for cervical intraepithelial neoplasia.
Obstet Gynecol, 91 (1998), pp. 263-269
[33.]
D.R. Ostergard.
Prediction of the clearance of cervical intraepithelial neoplasia by conization.
Obstet Gynecol, 56 (1980), pp. 77-80
[34.]
J.B. Murdoch, P.R. Morgan, A. Lopes, J.M. Monaghan.
Histological incomplete excision of CIN after large loop excision of the transformation zone merits careful follow up, not retreatment.
Br J Obst Gynaecol, 99 (1992), pp. 990-993
[35.]
R.W. Naumann, M.C. Bell, R.D. Álvarez, R.P. Edwards, E.E. Partridge, C.W. Helm, et al.
LLETZ is an acceptable alternative to diagnostic cold knife conization.
Gynecol Oncol, 55 (1994), pp. 224-228
[36.]
J.E. Hall, J.G. Boyce, J.H. Nelson.
Carcinoma in situ of the uterine cervix. A study of 409 patients.
Obstet Gynecol, 34 (1969), pp. 221-225
[37.]
T.c. Wrigh, R.M. Richart, A. Ferency, J. Koulos.
Comparision of specimens removed by CO2 laser conization and loop electrosurgical excision procedure.
Obstet Gynecol, 79 (1992), pp. 147-153
[38.]
M.S. Baggish, F. Barash, Y. Noel, M. Brooks.
Comparision of thermal injury zones in loop electrical and laser cervical excisional conization.
Am Obst Gynecol, 166 (1992), pp. 545-548
Copyright © 2004. Sociedad Española de Ginecología y Obstetricia
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