The Effect Of Different Surgical Treatment On High Grade Squamous Intraepithelial Lesions Of The Cervix

Objective: We retrospectively analyzed the three groups of surgical treatment for HSIL,including postoperative pathology,length of operation,length of stay and postoperative follow-up,so as to get the best diagnosis and treatment plan of HSIL.At the same time,the appropriate clinical treatment of the patients with positive margin of cutting edge after HSIL cervical conization was discussed.Methods: This study retrospectively analyzed 130 patients from Hebei People's Hospital in 2015 01 to 2016 07,who had the highest diagnostic level of HSIL.The following three groups were divided into three groups: cervical loop electrocision(LEEP)group,cervical cold knife coning(CKC)group or total hysterectomy(hysterectomy)group.The positive patients with 35 cases of primary cervical conization were also divided into three groups.Then the hysterectomy group,the CKC group and the follow-up observation group were performed.The pathological changes,intraoperative bleeding,postoperative follow-up and complications were compared before and after the operation.Results: There was no statistical difference between the three groups.The operation time of group LEEP was the shortest and the amount of intraoperative bleeding was the least.The operation time of the total hysterectomy group was longer than that of the CKC group,and the amount of bleeding was more in the operation.3 months after the operation,the positive rate of HPV in the total hysterectomy group was lower than that of the other two groups,and the difference was not statistically significant.The follow-up results of three groups of 35 patients with positive margin after primary cervical conization showed no significant difference in postoperative residual rate and recurrence rate.Conclusion: For patients with HSIL,conization should be the first-choice,and then the treatment and follow-up plan should be further dec-ided according to postoperative pathology,margin status and patient's fertility wish.If the incisal margin is positive after the first cervical conization,there is no pathological upgrade.We should follow closely the observation.At the same time,we should fully evaluate the patient's age,fertility requirements,personal wishes,family history and follow-up conditions,etc.