Comparison of effects of hysterectomy at two different timings in patients with high-grade squamous intraepithelial lesion

Abstract

Objective To compare the curative effects on high-grade squamous intraepithelial lesion (HSIL) by performing total hysterectomy (LTH) immediately after fast frozen section examination (FSE) and performing total hysterectomy after fast FSE frozen section examination and conventional pathological determination. Methods Eighty-four patients with HSIL diagnosed in Pathology Department of the First Affiliated Hospital of Zhengzhou University from January 2016 to April 2017 who were going to have total hysterectomy operation were divided into two groups by their own willingness on operation. Patients in one-step operation group were given cervical cold knife conization (CKC) for FSE; if patients were diagnosed as non-cancer by FSE, patients underwent total hysterectomy immediately. Patients in two-step group underwent CKC for FSE first; if patients were diagnosed as non-cancer by FSE, clinicians ended the surgery; then, patients experienced routine pathological examination; if the results of pathological examination proved not to be cancer, patients underwent total hysterectomy; if the FSE showed a cancer result, patients underwent the radical operation of cervical cancer. The hospital stay, treatment coast, intraoperative bleeding volume, postoperative complication, anxiety degree and inappropriate rate of operation were compared between the two groups. Results Compared to two-step group, one-step group had shorter hospital stay, less hospital coast, lower anxiety degree and shorter time for the first anal exhaust (P 0.05). Conclusions Performing CKC and total hysterectomy at the same time has more advantages, however, it also has limited accuracy. Therefore, clinicians should attach importance to prevention of inappropriate hysterectomy, and investigation on high-risk of exacerbation of HSIL to guide the formulation of treatment protocol. Key words: Hysterectomy; High-grade intraepithelial lesion; Treatment; Fast frozen section examination; Conventional paraffin pathology