Cargando…

An electrical scalpel conization versus Shimodaira-Taniguchi conization procedure for cervical intraepithelial neoplasia

The incidence of cervical intraepithelial neoplasia(CIN) among reproductive-aged women has increased in Japan. Cervical conization is commonly applied for local cervical treatment to preserve fertility. The Shimodaira-Taniguchi (S-T) conization procedure is widely used in Japan. S-T conization uses...

Descripción completa

Detalles Bibliográficos
Autores principales: Kigure, Keiko, Nakamura, Kazuto, Kitahara, Yoshikazu, Nakao, Kohshiro, Hirakawa, Takashi, Rokukawa, Shunichi, Ito, Masahiro, Nishimura, Toshio, Ito, Ikuro, Kagami, Issei, Itoga, Shunichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203509/
https://www.ncbi.nlm.nih.gov/pubmed/30313051
http://dx.doi.org/10.1097/MD.0000000000012640
_version_ 1783365889241907200
author Kigure, Keiko
Nakamura, Kazuto
Kitahara, Yoshikazu
Nakao, Kohshiro
Hirakawa, Takashi
Rokukawa, Shunichi
Ito, Masahiro
Nishimura, Toshio
Ito, Ikuro
Kagami, Issei
Itoga, Shunichi
author_facet Kigure, Keiko
Nakamura, Kazuto
Kitahara, Yoshikazu
Nakao, Kohshiro
Hirakawa, Takashi
Rokukawa, Shunichi
Ito, Masahiro
Nishimura, Toshio
Ito, Ikuro
Kagami, Issei
Itoga, Shunichi
author_sort Kigure, Keiko
collection PubMed
description The incidence of cervical intraepithelial neoplasia(CIN) among reproductive-aged women has increased in Japan. Cervical conization is commonly applied for local cervical treatment to preserve fertility. The Shimodaira-Taniguchi (S-T) conization procedure is widely used in Japan. S-T conization uses a high-frequency current and a triangular probe with a linear excision electrode to remove cervical tissue as a single informative specimen. However, alternative of an electrosurgical scalpel (ES) has the advantage of adjusting the surgical margin to the transformation zone in order to preserve the maximum amount of healthy cervical tissue with good hemostasis. The aim of this study is to retrospectively analyze data regarding surgical margin status, perioperative adverse events, cervical stenosis, and preterm birth between S-T and ES. Between January 2009 and December 2014, the medical records of 1166 patients who were diagnosed as CIN II, III, or stage 1a1 cervical cancer and who were treated with conization in 7 hospitals in Gunma Prefecture, Japan were enrolled for this retrospective study. The clinicopathological data was analyzed to statistically compare outcome between S-T and ES conization. There was no difference for age or post-operative follow-up period between ES and S-T treatments. However, positive surgical margins were significantly less frequent in patients who were treated with S-T than in those treated with ES, resulting in a reduced incidence of re-treatment for S-T in comparison with ES patients. In perioperative adverse events, S-T had more patients who were administered antibiotics. The incidence of preterm delivery and cervical stenosis did not differ significantly between the groups. We demonstrate here that S-T is an alternative procedure for cervical conization with a low risk of recurrence and acceptably low rate of adverse events such as cervical stenosis and preterm delivery. The results of this study can provide useful information for future management of patient with cervical intraepithelial neoplasia.
format Online
Article
Text
id pubmed-6203509
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-62035092018-11-07 An electrical scalpel conization versus Shimodaira-Taniguchi conization procedure for cervical intraepithelial neoplasia Kigure, Keiko Nakamura, Kazuto Kitahara, Yoshikazu Nakao, Kohshiro Hirakawa, Takashi Rokukawa, Shunichi Ito, Masahiro Nishimura, Toshio Ito, Ikuro Kagami, Issei Itoga, Shunichi Medicine (Baltimore) Research Article The incidence of cervical intraepithelial neoplasia(CIN) among reproductive-aged women has increased in Japan. Cervical conization is commonly applied for local cervical treatment to preserve fertility. The Shimodaira-Taniguchi (S-T) conization procedure is widely used in Japan. S-T conization uses a high-frequency current and a triangular probe with a linear excision electrode to remove cervical tissue as a single informative specimen. However, alternative of an electrosurgical scalpel (ES) has the advantage of adjusting the surgical margin to the transformation zone in order to preserve the maximum amount of healthy cervical tissue with good hemostasis. The aim of this study is to retrospectively analyze data regarding surgical margin status, perioperative adverse events, cervical stenosis, and preterm birth between S-T and ES. Between January 2009 and December 2014, the medical records of 1166 patients who were diagnosed as CIN II, III, or stage 1a1 cervical cancer and who were treated with conization in 7 hospitals in Gunma Prefecture, Japan were enrolled for this retrospective study. The clinicopathological data was analyzed to statistically compare outcome between S-T and ES conization. There was no difference for age or post-operative follow-up period between ES and S-T treatments. However, positive surgical margins were significantly less frequent in patients who were treated with S-T than in those treated with ES, resulting in a reduced incidence of re-treatment for S-T in comparison with ES patients. In perioperative adverse events, S-T had more patients who were administered antibiotics. The incidence of preterm delivery and cervical stenosis did not differ significantly between the groups. We demonstrate here that S-T is an alternative procedure for cervical conization with a low risk of recurrence and acceptably low rate of adverse events such as cervical stenosis and preterm delivery. The results of this study can provide useful information for future management of patient with cervical intraepithelial neoplasia. Wolters Kluwer Health 2018-10-12 /pmc/articles/PMC6203509/ /pubmed/30313051 http://dx.doi.org/10.1097/MD.0000000000012640 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle Research Article
Kigure, Keiko
Nakamura, Kazuto
Kitahara, Yoshikazu
Nakao, Kohshiro
Hirakawa, Takashi
Rokukawa, Shunichi
Ito, Masahiro
Nishimura, Toshio
Ito, Ikuro
Kagami, Issei
Itoga, Shunichi
An electrical scalpel conization versus Shimodaira-Taniguchi conization procedure for cervical intraepithelial neoplasia
title An electrical scalpel conization versus Shimodaira-Taniguchi conization procedure for cervical intraepithelial neoplasia
title_full An electrical scalpel conization versus Shimodaira-Taniguchi conization procedure for cervical intraepithelial neoplasia
title_fullStr An electrical scalpel conization versus Shimodaira-Taniguchi conization procedure for cervical intraepithelial neoplasia
title_full_unstemmed An electrical scalpel conization versus Shimodaira-Taniguchi conization procedure for cervical intraepithelial neoplasia
title_short An electrical scalpel conization versus Shimodaira-Taniguchi conization procedure for cervical intraepithelial neoplasia
title_sort electrical scalpel conization versus shimodaira-taniguchi conization procedure for cervical intraepithelial neoplasia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203509/
https://www.ncbi.nlm.nih.gov/pubmed/30313051
http://dx.doi.org/10.1097/MD.0000000000012640
work_keys_str_mv AT kigurekeiko anelectricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT nakamurakazuto anelectricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT kitaharayoshikazu anelectricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT nakaokohshiro anelectricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT hirakawatakashi anelectricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT rokukawashunichi anelectricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT itomasahiro anelectricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT nishimuratoshio anelectricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT itoikuro anelectricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT kagamiissei anelectricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT itogashunichi anelectricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT kigurekeiko electricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT nakamurakazuto electricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT kitaharayoshikazu electricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT nakaokohshiro electricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT hirakawatakashi electricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT rokukawashunichi electricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT itomasahiro electricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT nishimuratoshio electricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT itoikuro electricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT kagamiissei electricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia
AT itogashunichi electricalscalpelconizationversusshimodairataniguchiconizationprocedureforcervicalintraepithelialneoplasia