Expert Profile: Lihau Qiu, Deputy Director of Gynecology and Obstetrics, Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine, MD, professor, chief physician and doctoral supervisor. Specializing in the diagnosis and treatment of cervical cancer and precancerous lesions, vaginal intraepithelial lesions, vulvar lesions and lower reproductive tract infectious diseases.
Ms. Zhao, 26, lived with her boyfriend for 2 years. Recently, she wants to go to the hospital for a 9-valent HPV vaccine. However, the preliminary screening results showed that she was high-risk human papillomavirus positive, and TCT cytology showed high-grade lesions.
Zhao Nvshi was very worried and had a colposcopy cervical biopsy. The report shows that CIN III. At the doctor's suggestion, Ms. Zhao accepted LEEP knife cervical conization.
1, what is high-grade cervical lesions?
The cervix, the cervix, is located in the lower part of the uterus and is 2.5 3 cm long. The upper end is connected with the uterine body, and the lower end goes deep into the vagina.
Cervical cancer is a cancer that occurs in the cervix. It is a long process from normal cervix to cervical precancerous lesion and then to cervical cancer, which takes about 5- 15 years.
Cervical intraepithelial neoplasia (CIN) refers to the replacement of cervical epithelium by atypical cells in different degrees (that is, cells with different morphology and structure from normal epithelium).
According to the degree of lesion, cervical intraepithelial neoplasia can be divided into CIN 1.3 grades, with the lesion getting worse step by step and the risk of cancer increasing step by step. CIN 1 is called low-grade cervical intraepithelial neoplasia, and most of them will turn normal by themselves.
CIN2 3 is called high-grade cervical lesion, which belongs to cervical precancerous lesion. If not treated in time, the possibility of developing cervical cancer is greatly increased, and cervical conization surgery is generally used for treatment.
2. What is LEEP taper cutting?
LEEP, that is, loop electrosurgical excision procedure, is to generate ultra-high frequency radio waves through loop wires (loop electrodes), and the tissue itself generates impedance, which generates high fever after absorbing the radio waves, thus completing various operations such as cutting and hemostasis. It is a common method to treat cervical diseases in China and can effectively prevent cervical cancer.
LEEP has the advantages of simple operation, short operation time, less bleeding, less complications and good cervical shaping.
3. What are the indications for 3.LEEP?
LEEP is mainly used to treat cervical precancerous lesions, such as cervical high lesion (CIN2 3) and 25-year-old CIN 1 with ASC-H and HSIL cytological examination. When cervical biopsy is HSIL or carcinoma in situ but clinically suspected as invasive carcinoma, LEEP can determine the degree of lesion involvement and provide reference for the scope of operation.
In addition, cervical carcinoma in situ and early cervical cancer with fertility demand (IA 1 stage) can also be considered for LEEP.
The depth of surgical resection will affect the cure rate. Doctors should determine the scope of LEEP operation according to the condition, so as to avoid complications caused by too much or too little tissue resection and affect the treatment effect.
4. How does 4.LEEP do it?
Menstruation is clean for 37 days, bladder can be emptied before operation, and local anesthesia or intravenous anesthesia can be used.
First, it is suggested that colposcopy should be used to evaluate cervical lesions, and acetic acid or compound iodine solution should be used to determine the scope of lesions. Then choose LEEP knife head with appropriate size to remove cervical lesions 3 5 mm away from cervical lesions.
Finally, the bleeding points such as the edge and bottom of the wound were stopped with spherical electrodes.
5. Does cervical erosion need LEEP surgery?
No, cervical erosion is the physiological manifestation that the cervical development increases under the action of estrogen, which makes the columnar epithelium in the cervical canal move out and present a fine granular red area. Leep is an overuse in the treatment of cervical erosion.
When a part of cervical tissue is removed, scar tissue will be produced during the repair process, which may cause cervical adhesion, cervical canal stenosis and cervical endometriosis, and cervical shortening may lead to abortion or premature delivery. Therefore, overtreatment should be avoided.
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