宫颈锥切术

Cone Biopsy of Cervix

Cone biopsy

                               
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Definition

A cone biopsy is really a surgical treatment when a cone-shaped tissue sample in the cervix is taken away for evaluation. Also known as cervical conization, a cone biopsy is performed to identify cervical cancer in order to take out cancerous or precancerous tissue.

Demographics

The chance of building cervical cancer heightens as we grow older via a woman's 20’s and 30’s; the danger remains comparable for ladies older than 40. Minority ladies and women of low socioeconomic status have higher rates of cervical cancer as well as an enhanced mortality rate.

Purpose

The cervix may be the neck-shaped opening in the lower the main uterus. When cervical cancer is discovered and treated continuing, however, the long-term rate of survival is nearly 100%. A cone biopsy is conducted to identify cancer from the cervix in order to identify precancerous changes. The process is often suggested if patient’s Pap test shows the existence of abnormal cells. In some instances, a cone biopsy can be utilized like a conservative treatment for cervical cancer for ladies who would like to avoid a hysterectomy.

Description

The process is carried out using the patient lying on her behalf back together with her legs in stirrups. General anesthesia is often used, although regional or local anesthesia could also be used. A speculum is placed to the vagina to keep it open during surgery. There are many different techniques which may be accustomed to execute a cone biopsy. Cold-knife conization may be the elimination of a cone-shaped wedge of tissue having a scalpel (surgical knife). The tissue can also be taken out utilizing a co2 laser called laser conization. A loop electrosurgical excision procedure (leep) utilizes low-voltage, high-frequency radio waves to excise the tissue. Some doctors decide to cover outdoors cervical tissue with flaps of tissue stitched into place. The tissue sample will be analyzed within microscope for that existence of cancerous cells. If abnormal cells are simply round the fringe of the biopsy, then further surgery is going to be necessary to excise any remaining cancer. When there is proof of invasive cancer, then anything else more extensive surgery, chemotherapy, and/or radiation might be suggested.

Diagnosis/Preparation

Numerous tests might be carried out just before cone biopsy to find out if precancerous or cancerous cells exist. A Pap test involves scraping the cervix for any sample of cells after which staining and evaluating cells for just about any irregularities. Colposcopy is really a treatment which allows patient’s physician to look at a ladies cervix and vagina utilizing a special microscope known as a colposcope. A cervical biopsy requires the extraction of the smaller tissue sample and it is less invasive than the usual cone biopsy. In line with the outcomes of these tests, a cone biopsy might be pointed out if mild to extreme cell irregularities are simply. As cone biopsy is often executed under general anesthesia, the individual is generally directed to avoid consuming meals after midnight before the time of surgery.

Who performs the process and where could it be carried out?

A cone biopsy is generally carried out with a gynecologist who focuses on other locations of women's general and reproductive health, pregnancy, labor and delivery, and prenatal testing. Tissue samples are examined with a pathologist who focuses on diagnosing of diseases from microscopic analysis of cells and tissues. The process is generally done with an outpatient basis inside a hospital or physician's office.

Risks

Bleeding during and after cone biopsy is easily the most common problem. Rarely, uncontrolled bleeding throughout the process may lead to an urgent situation hysterectomy. Other potential difficulties include a reaction to the anesthesia, infection from the biopsy site, problems for the uterus or other tissues, cervical stenosis once the cervical canal narrows or becomes closed, and failure to get rid of all cancerous tissue. If an excessive amount of tissue is taken away throughout a cone biopsy so the internal opening from the cervix towards the uterus known as the internal os is affected, a female might have problems carrying a pregnancy to term, growing her risk of miscarriage or premature birth.

Morbidity and mortality rates

Two to 8% of ladies who undergo a cone biopsy are experiencing bleeding for approximately fourteen days. One study discovered that cervical stenosis takes place for a price of 3%-8%, with respect to the approach to conization.

Normal results

Numerous researches have pointed out that cone biopsy works in excising all cancerous tissue in 90% of patients with cervical cancer.

Important questions a patient should ask a doctor

• How long will the process take?
• Why is really a cone biopsy advisable with such case?
• What may happen when the answers are positive for cancer or another abnormality?
• How will the biopsy be taken out?
• When a patient going to know the outcomes?
  

Aftercare

Following the process, the individual may feel some cramping, soreness, or mild to moderate bleeding. The biopsy site might take as much as 6 weeks to totally heal. The individual is going to be instructed to prevent intercourse, tampons, and douches not less than 3 weeks following a procedure.

Alternatives

Cryotherapy or laser vaporization enables a patient to treat early-stage cancer. A hysterectomy might be essential to take out more invasive cancer. Inside a subtotal hysterectomy, just the uterus is taken away. Inside a radical hysterectomy, the uterus, cervix, ovaries, fallopian tubes, lymph nodes, and lymph channels are taken out. The kind of hysterectomy carried out depends upon what lengths cancer has spread. In most cases, menstruation stops along with a woman loses a chance to bear children.