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With cases of cervical cancer pre-cancerous or early stage, cervical conesection with electric ring is an effective treatment method, helping to preserve the uterus, fertility and life of the patient. .
1. Cervical Cancer Overview
Cervical cancer is a common cancer in women but can be prevented, detected early (when the cancer is still in the precancerous stage or localized) and cured. The period of formation of cervical cancer lasts about 5 - 20 years. Symptoms of the disease are usually persistent white discharge, abnormal vaginal bleeding after sexual activity, or vaginal bleeding after menopause.
To detect the disease early, women should have regular gynecological exams, perform Pap smear, cytology, colposcopy and cervical biopsy if there are abnormal signs. Each stage of the disease will have a corresponding treatment method. Specifically:
Pre-cancerous stage: This is the stage of carcinoma in situ, the abnormal cells only appear in the surface lining of the cervix, have not penetrated into the main tissue and have not spread to the other organs. other parts of the body. At this stage, the doctor has many local treatments, keeping the function of the uterus and ovaries, such as: cervicectomy with electric ring (removing a small part of the cervix in a cone), surgery by ring ablation, laser treatment or freezing of cancer cells with liquid nitrogen,... The cure rate in this stage can be up to 100%; Stage I: Cancer has invaded major tissues of the cervix but has not spread to other organs. Treatment is partial or total hysterectomy, or radiation therapy. Scar tissue left behind after surgery can narrow the cervix, prevent the egg and sperm from meeting, affecting the ability to conceive. If too much tissue is removed, a woman who becomes pregnant again has a high risk of miscarriage. Cervical cancer cure rate completely cured in stage II is quite high, can reach 85 - 90%; Stages II - III: The tumor has begun to spread to the vagina and surrounding tissues of the cervix, and even to the pelvis. The main treatment is radiation therapy combined with chemotherapy, which does not preserve the patient's fertility. In some cases, surgery can remove the uterus and ovaries, combined with radiation and chemotherapy. Patients in stage II have a 50-75% chance of being cured and reduced to 25-40% if treated in stage III; Stage IV: The malignant tumor has spread beyond the pelvis to nearby organs such as bladder, rectum or metastasized to distant organs such as liver, lung, bone,... At this stage, the treatment Cervical cancer treatment only aims to prolong survival time and reduce uncomfortable symptoms for patients. Only up to 15% of patients with stage IV cervical cancer can live another 5 years.
Ung thư cổ tử cung là loại ung thư thường gặp ở phụ nữ nhưng có thể phòng ngừa, phát hiện sớm
2. Treatment of early cervical cancer by electric ring cone technique
Currently, there are many treatment methods for early cervical cancer such as local anti-inflammatory, cryotherapy, electrocautery, laser burning, electric knife cone, electric ring,... In which, cone incision Loop electrosurgical excision procedure (LEEP) is a technique that many doctors prescribe for patients.
2.1 What is electrocautery cervicectomy? When a patient has abnormal cervical cancer screening results, the doctor may recommend an electrocardiogram as part of the evaluation or treatment of the disease. This is a method of removing abnormal cells in the cervix using an electric loop (LOOP) that functions like a surgical knife. An electric current will be directed through this ring, cutting away a thin layer of the cervix (cervical cone).
This technique has the advantages of being easy to use, low cost, good hemostasis thanks to the effect of the electric ring and ball electrode, getting enough intact specimens to send for tissue testing after the procedure. . The aim of the technique is to treat precancerous lesions of the cervix (mild to severe epithelial dysplasia) and some benign lesions of the cervix such as treated cervical ectropion. Cryotherapy but ineffective, cervical fibroids, cervical polyps.
2.2 Indications and contraindications Technical indications: Cervical cone resection is indicated in the following cases (according to histopathological results):
High-grade cervical epithelial dysplasia; Low grade cervical epithelial dysplasia but no correspondence between cytological, colposcopy and pathologic findings or the squamous-column border is not completely visible; Cervical ectropion has been treated with cryotherapy or electrocautery but to no avail.
Kỹ thuật khoét chóp cổ tử cung chống chỉ định với những người mắc các bệnh về tim mạch, huyết áp chưa được điều trị ổn định
Technical contraindications:
People with cardiovascular diseases, diabetes, blood pressure have not been treated stably; Patients with coagulopathy; Patients with moderate to severe pelvic inflammatory disease. 2.3 How to perform cervical cone incision with electric ring? Electric ring cone technique for early cervical cancer treatment is performed when the patient is not menstruating so that the cervix can be clearly observed. Usually, the procedure only lasts a few minutes.
During the procedure, the patient will lie on his back with his feet on the support. Then, the doctor will put a speculum into the vagina, injecting local anesthetic to reduce pain for the patient. The coil will be inserted into the cervix through the vagina. The coil comes in many shapes and sizes, and the type chosen will depend on the patient's cervix and the size of the lesion to be cut.
After the procedure is complete, a paste will be applied to the cervix to stop bleeding. Electrocautery can also be used to stop bleeding. Tissue removed from the apical procedure will be sent for testing to confirm the diagnosis.
After the procedure, the patient may notice a pink, loose vaginal discharge, slight cramping or a dark brown vaginal discharge (caused by the paste). It will take a few weeks for the cervix to heal completely. While waiting for the cervix to heal, the patient should not put anything in the vagina, do not have sex without the consent of the doctor. If there are abnormal symptoms such as menstrual bleeding more than usual, bleeding with blood clots, abdominal pain, ... the patient needs to be checked immediately. Finally, the patient needs to be re-examined according to the doctor's advice.
Currently, at Vinmec International General Hospital, cervical cone dilation by electric ring (LEEP) is performed for effective cervical cancer treatment and screening. Patients can be completely assured with the advantages of ease of use, low cost, good hemostasis and especially the ability to remove cervical cancer cells very effectively.
After the procedure, you will have to see the doctor after 1 week and if normal, you will have a gynecological examination every 6 months. You will have cervical cancer screening tests again to make sure all abnormal cells are completely gone and to make sure they don't come back. If abnormal cervical tissue continues to be detected, the patient is likely to require further aggressive treatment.
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