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Surgery for cervical intraepithelial neoplasiaMartin-Hirsch PPL, Paraskevaidis E, Kitchener HC
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SummarySurgery for cervical intraepithelial neoplasiaNo clear evidence to show any optimal surgical technique is superior for treating pre-cancerous cervix abnormalities.Cervical pre-cancer (cervical intraepithelial neoplasia) can be treated in different ways depending on the severity of the disease. Less invasive treatments not requiring a hospital stay may be used, but a general anaesthetic is occasionally needed, especially if the tumour has spread locally or previous out-patient treatment has failed. Surgery can be done with a knife, laser or cutting with a loop (an electrically charged wire). This review found there was not enough evidence to compare techniques and that more research is needed.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
October 26. 1998 AbstractBackgroundCervical intra-epithelial neoplasia is treated by local ablation or lower morbidity excision techniques. Choice of treatment depends on the severity of the disease. ObjectivesThe objective of this review was to assess the effects of alternative surgical treatments for cervical intra-epithelial neoplasia. Search strategyWe searched the Cochrane Gynaecological Cancer Group trials register and MEDLINE up to July 1997. Update: in July 2004 a further search was conducted. Selection criteriaRandomised and quasi-randomised trials of alternative surgical treatments in women with cervical intra-epithelial neoplasia. Data collection and analysisTrial quality was assessed and two reviewers abstracted data independently. Main resultsTwenty eight trials were included. Seven surgical techniques were tested in various comparisons. No significant difference in eradication of disease was shown, other than between laser ablation and loop excision. This was based on one trial where the quality of randomisation was doubtful. Large loop excision of the transformation zone appeared to provide the most reliable specimens for histology with the least morbidity. Morbidity was lower than with laser conisation, although all five trials did not provide data for every outcome. There were not enough data to assess the effect on morbidity compared with laser ablation. Authors' conclusionsThe evidence suggests that there is no obviously superior surgical technique for treating cervical intra-epithelial neoplasia. |